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Wisconsin 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 $117 · 10th–90th $105$2140%20%40%10th90th$117Professionalmedian $79 · 10th–90th $51$1780%20%10th90th$79$0.1$0.5$2.0$10.0$50.0$200.0

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
$57.54 / $57.54 / $57.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $58.88 / $100.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $194.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $109.65 / $131.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $269.15 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $165.96 / $223.87
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $95.50 / $144.54
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $141.25 / $181.97
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $114.82 / $537.03
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $60.26 / $128.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $58.88 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $131.83 / $229.09
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $177.83 / $323.59
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $234.42 / $537.03
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $93.33 / $588.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $60.26 / $117.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $57.54 / $97.72