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Massachusetts 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
$208.93 / $208.93 / $208.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $229.09 / $602.56
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $489.78 / $2,398.83
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $338.84 / $489.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $275.42 / $831.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $446.68 / $562.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.42 / $275.42 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $173.78 / $251.19
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $4,897.79 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $416.87 / $630.96
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $257.04 / $288.40
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $489.78 / $2,398.83
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $363.08 / $489.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.30 / $213.80 / $512.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $257.04 / $416.87