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Montana rates for HCPCS L3984

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

Facilitymedian $427 · 10th–90th $269–$1,2880%20%10th90th$427Professionalmedian $269 · 10th–90th $191–$4270%20%10th90th$269$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $245.47 / $407.38
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $69,183.10 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $457.09 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $457.09 / $457.09
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $426.58 / $831.76
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $426.58 / $831.76
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $407.38 / $524.81
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $346.74 / $457.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $213.80 / $234.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $190.55 / $288.40