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Washington rates for HCPCS L3917

Hand orthosis (HO), metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Facilitymedian $112 · 10th–90th $76$2510%10%10th90th$112Professionalmedian $76 · 10th–90th $49$1620%10%10th90th$76$1.0$5.0$20.0$100.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $64.57 / $104.71
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $109.65 / $109.65
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $64.57
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $147.91 / $316.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $134.90 / $239.88
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $87.10 / $95.50
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $109.65 / $114.82
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $117.49
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $165.96 / $223.87
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $109.65
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $169.82 / $169.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $56.23 / $97.72
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $81.28 / $173.78