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Other Upper Limb Orthosis

Washington rates for HCPCS L3999

Upper limb orthosis, not otherwise specified

Rates data updated October 2026.

How much does Other Upper Limb Orthosis cost?

$5.62

Typical facility fee. In Washington, October 2026.

Insurers have agreed to pay about $5.62 for this service. Most negotiated rates run $1.17 to $44.67.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $1,096 · 10th to 90th $55 to $1,096Professionalmedian $6 · 10th to 90th $1 to $76
$2$10$50$200$1Kfacility $1,096professional $6

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Asuris Northwest Health
Setting
Facility
Modifier
None
Typical Low
$54.95
Median
$54.95
Typical High
$54.95
Cigna
Setting
Facility
Modifier
None
Typical Low
$34.67
Median
$34.67
Typical High
$34.67
Cigna
Setting
Professional
Modifier
None
Typical Low
$1.17
Median
$5.25
Typical High
$5.62
Molina
Setting
Professional
Modifier
None
Typical Low
$44.67
Median
$64.57
Typical High
$93.33
Pacific Source
Setting
Facility
Modifier
None
Typical Low
$1,096.48
Median
$1,096.48
Typical High
$1,096.48

Where Washington sits

The same service costs 426.6 times more in Georgia than in Rhode Island. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Washington· 11th of 51

$5.62

GA $501RI $1.17

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.