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Arkansas rates for HCPCS L3984

Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$168.55 / $175.80 / $221.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.64 / $221.46 / $227.90
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.74 / $318.74 / $318.74
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$343.94 / $455.22 / $505.80
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$379.44 / $379.44 / $449.45
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$379.44 / $379.44 / $379.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.12 / $237.10 / $318.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.08 / $237.10 / $311.26
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$366.55 / $366.55 / $366.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.20 / $187.61 / $255.20