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Tennessee 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
Facility
Modifier
Low / Median / High Price
$100.00 / $109.65 / $177.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $109.65 / $194.98
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $144.54 / $190.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $169.82 / $177.83
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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,230.27 / $1,230.27
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,584.89 / $1,584.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $100.00 / $158.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $107.15 / $144.54