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Arizona rates for HCPCS L3984

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.37 / $227.90 / $393.56
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$325.00 / $379.44 / $505.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.82 / $479.83 / $867.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$332.06 / $442.74 / $603.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$237.10 / $237.10 / $237.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.08 / $173.08 / $439.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.21 / $338.05 / $2,002.53
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.92 / $189.30 / $285.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.09 / $189.30 / $285.14