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Pennsylvania 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
$234.42 / $912.01 / $912.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $295.12 / $478.63
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $436.52 / $446.68
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $575.44 / $575.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.38 / $128.82 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $239.88 / $323.59
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $758.58 / $1,096.48
Geisinger
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $575.44 / $575.44
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $407.38 / $575.44
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $426.58 / $426.58
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.42 / $234.42 / $912.01
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $302.00 / $524.81
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.70 / $53.70 / $912.01
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $44.67 / $64.57
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $416.87 / $537.03
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $416.87 / $549.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $707.95 / $851.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $281.84 / $537.03