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Utah rates for HCPCS L3984

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

Facilitymedian $162 · 10th–90th $123–$4370%50%10th90th$162Professionalmedian $263 · 10th–90th $170–$5010%10%10th90th$263$50.0$100.0$200.0$500.0$1.0K$2.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $162.18 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $251.19 / $501.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $234.42
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $316.23 / $416.87
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $436.52 / $436.52
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $309.03 / $446.68
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $436.52 / $446.68
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $446.68 / $489.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $186.21 / $251.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $190.55 / $346.74