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Nebraska 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
$369.90 / $369.90 / $369.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$369.90 / $369.90 / $480.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$509.80 / $560.77 / $566.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$325.37 / $638.03 / $638.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$620.66 / $675.75 / $983.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$369.90 / $634.90 / $2,714.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.84 / $289.37 / $453.98
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$636.17 / $638.03 / $803.91
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$607.41 / $764.69 / $1,314.47
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$582.88 / $636.75 / $1,183.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$209.79 / $289.37 / $453.98