Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
SPLINT ORTHO LG 11IN LT FOREARM WRIST NON-PERFORATED PALMAR/DORSAL STAY HK-LOOP CLOSURE BROWN
Low
$199
Average
$227
Median
$210
High
$271
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5 hospital rates
iThe hospitals that file a Bcbs Vt rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Cheshire Medical Center Keene, NH facility · fee schedule · outpatient | 1 | $268 | $268 | — | — | — | $268 – $268 |
| 2 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 4 | $180 | $191 | $19 | 10% | — | $180 – $223 |
| 3 | Mary Hitchcock Memorial Hospital Lebanon, NH facility · fee schedule · outpatient | 1 | $268 | $268 | — | — | — | $268 – $268 |
| 4 | Mary Hitchcock Memorial Hospital Lebanon, NH professional · fee schedule · outpatient | 2 | $272 | $272 | $4 | 1% | — | $268 – $276 |
| 5 | University of Vermont Medical Center Inc Colchester, VT facility · percent of total billed charges · outpatientfrom % of charges | 2 | $234 | $210 | $74 | 35% | — | $91 – $365 |
← Payers reporting HCPCS L3809 · Snapshot 20261111T120946Z-9134e7f7