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Other Upper Limb Orthosis

Wisconsin rates for HCPCS L3999

Upper limb orthosis, not otherwise specified

Rates data updated July 2026.

Facilitymedian $132 · 10th–90th $55$1320%50%10th$132Professionalmedian $25 · 10th–90th $1$4270%20%10th90th$25$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$131.83
Typical High
$131.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$61.66
Typical High
$426.58
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$2,511.89
Median
$2,511.89
Typical High
$2,511.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$34.67
Typical High
$34.67
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.17
Median
$5.62
Typical High
$5.62
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$54.95
Medica
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$54.95
Typical High
$112.20
Molina
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$58.88
Typical High
$70.79
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$54.95
Quartz
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$64.57
Typical High
$112.20
Quartz
Setting
Professional
Modifier
Global
Typical Low
$1.17
Median
$5.62
Typical High
$5.62
United
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$79.43