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Louisiana rates for HCPCS L3916

Wrist Hand Orthosis Includes One Or More Non- Torsion Joint(S) Elastic Bands Turnbluckes May Include Soft Interface Straps Prefabricated Offthe Shelf (Code Was Deleted 01/01/08 And Reinstated 01/01/14) Wrist Hand Finger Orthosis Wrist Extension Cock-Up With Outrigger Prefabricated Includes Fitting And Adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.72 / $336.21 / $452.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.31 / $336.21 / $365.45
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$510.06 / $871.37 / $1,224.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$347.83 / $416.06 / $416.06
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$325.37 / $325.37 / $325.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.52 / $237.52 / $675.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$183.39 / $278.20 / $458.64