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Other Upper Limb Orthosis

Utah rates for HCPCS L3999

Upper limb orthosis, not otherwise specified

Rates data updated July 2026.

Facilitymedian $5,012 · 10th–90th $5,012$5,0120%50%100%$5,012Professionalmedian $186 · 10th–90th $6$4270%20%10th90th$186$1.0$5.0$20.0$100.0$500.0$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$14.45
Median
$426.58
Typical High
$426.58
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.17
Median
$1.17
Typical High
$5.62
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$44.67
Typical High
$79.43
Select Health
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$5,011.87
Typical High
$5,011.87
Select Health
Setting
Professional
Modifier
Global
Typical Low
$2,511.89
Median
$5,011.87
Typical High
$5,011.87