go back

New Hampshire 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
$333.95 / $333.95 / $400.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.13 / $248.57 / $345.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$568.90 / $568.90 / $674.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$325.80 / $325.80 / $330.11
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 / $325.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$460.61 / $460.61 / $1,421.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.21 / $283.82 / $453.28