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Tennessee 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
$263.67 / $263.67 / $288.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.57 / $271.95 / $493.49
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$586.05 / $586.05 / $586.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.17 / $527.45 / $527.45
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 / $237.52
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$484.66 / $2,714.31 / $2,714.31
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,934.66 / $2,934.66 / $4,266.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.92 / $283.25 / $407.54