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Maine rates for HCPCS L3931

Wrist-hand-finger orthosis (WHFO), includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $120.23 / $346.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $269.15 / $309.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $123.03 / $158.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.89 / $125.89 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $91.20 / $125.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $199.53 / $239.88
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $128.82 / $346.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $100.00 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $123.03 / $213.80