go back

Minnesota 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
$263.64 / $263.64 / $263.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.37 / $227.90 / $330.45
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$327.02 / $405.01 / $533.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$303.55 / $360.47 / $379.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$237.10 / $1,171.10 / $3,252.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$439.88 / $466.27 / $558.64
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$695.27 / $1,123.61 / $2,561.15
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$439.88 / $439.88 / $452.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.88 / $379.44 / $2,002.53
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.20 / $211.39 / $408.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.20 / $199.11 / $405.10