go back

Missouri rates for HCPCS L3916

Wrist-hand orthosis (WHO), includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $302.00 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $316.23 / $588.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $588.84 / $2,089.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $331.13 / $575.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $354.81 / $588.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.59 / $323.59 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $239.88 / $323.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $457.09 / $1,288.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $288.40 / $2,951.21
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $537.03 / $537.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $467.74 / $549.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $281.84 / $446.68