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Washington rates for HCPCS L3999

Upper limb orthosis, not otherwise specified

Facilitymedian $1,096 · 10th–90th $1,096–$1,0960%50%$1,096Professionalmedian $14 · 10th–90th $1–$4270%10%20%10th90th$14$2.0$10.0$50.0$200.0$1.0K

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
$14.45 / $75.86 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $34.67
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.17 / $5.25 / $5.62
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.20 / $1.20 / $1.20
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.20 / $1.20 / $1.20
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $50.12 / $85.11
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48