go back

Nebraska 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
$275.42 / $275.42 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $245.47 / $501.19
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $257.04 / $346.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $436.52 / $446.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $234.42 / $512.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $501.19 / $776.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$288.40 / $501.19 / $1,995.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $229.09 / $436.52
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $501.19 / $1,148.15
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $512.86 / $512.86
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $1,148.15 / $1,148.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $218.78 / $436.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $218.78 / $346.74