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Wisconsin rates for HCPCS L3956

Addition Of Joint To Upper Extremity Orthosis Any Material; Per Joint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.66 / $17.66 / $17.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.66 / $17.66 / $48.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.00 / $76.00 / $252.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $143.53 / $152.82
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.66 / $17.66 / $31.79
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.66 / $31.79 / $90.90
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $58.40 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.66 / $17.66 / $31.79
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.40 / $87.40 / $90.90
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $19.50 / $19.50