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Washington rates for HCPCS L3995

Addition to upper extremity orthosis, sock, fracture or equal, each

Facilitymedian $40 · 10th–90th $27–$1020%10%10th90th$40Professionalmedian $27 · 10th–90th $18–$510%10%10th90th$27$0.5$2.0$10.0$50.0$200.0

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
$26.92 / $64.57 / $102.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $22.91 / $42.66
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $38.90 / $38.90
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $44.67
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $21.88 / $30.20
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $51.29 / $112.20
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $46.77 / $83.18
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $30.90 / $64.57
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $38.90 / $39.81
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $39.81 / $43.65
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $58.88 / $79.43
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $33.11 / $38.90
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $38.90
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $44.67
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.78 / $48.98 / $58.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.60 / $20.89 / $34.67
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $34.67 / $61.66