Prefabricated hand-finger orthosis without joints

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.

Model: claude-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HC Hfo W/O Jnt Prefab Custom by Expertise Tier1

Payers reporting HCPCS L3923

Payer pricing summary

Low

$15

Average

$113

Median

$101

High

$295

Payer rate distribution

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Filter by billing class

#
1	Molina fee schedule · outpatient · +20 other terms	164	$113	$114	$50	44%	3–30	$1 – $256
2	UnitedHealthcare fee schedule · outpatient · +26 other terms	426	$99	$110	$95	87%	—	$0 – $1.3k
3	Aetna fee schedule · outpatient · +25 other terms	397	$99	$177	$226	128%	—	$1 – $1.5k
4	Humana fee schedule · outpatient · +24 other terms	341	$98	$147	$175	119%	—	$1 – $1.5k
5	Blue Cross Blue Shield fee schedule · outpatient · +23 other terms	254	$100	$152	$121	80%	—	$0 – $1.3k
6	WellCare fee schedule · outpatient · +14 other terms	218	$101	$107	$26	25%	—	$11 – $355
7	Devoted fee schedule · outpatient · +13 other terms	165	$98	$98	$3	3%	—	$94 – $133
8	Cigna fee schedule · outpatient · +24 other terms	144	$101	$130	$126	97%	—	$1 – $1.1k
9	Cigna Healthspring fee schedule · outpatient · +5 other terms	116	$101	$100	$5	5%	—	$98 – $134
10	Anthem fee schedule · outpatient · +26 other terms	113	$98	$106	$112	106%	—	$5 – $810
11	Kaiser fee schedule · outpatient · +16 other terms	97	$100	$219	$181	83%	—	$1 – $789
12	Ambetter facility · fee schedule · outpatient · +16 other terms	51	$153	$153	$49	32%	—	$43 – $275
13	Caresource fee schedule · outpatient · +15 other terms	46	$106	$110	$61	56%	—	$1 – $750
14	Optum fee schedule · outpatient · +12 other terms	43	$98	$110	$51	46%	—	$18 – $245
15	MultiPlan fee schedule · outpatient · +18 other terms	41	$107	$187	$293	157%	—	$21 – $1.7k
16	Superior Healthplan fee schedule · outpatient · +3 other terms	40	$103	$103	$0	0%	—	$96 – $103
17	Clover fee schedule · outpatient · +3 other terms	37	$98	$100	$6	6%	—	$96 – $130
18	Oscar fee schedule · outpatient · +12 other terms	37	$103	$114	$25	22%	—	$96 – $170
19	Medica facility · fee schedule · outpatient · +14 other terms	29	$96	$89	$28	32%	—	$4 – $151
20	Medicare fee schedule · both · +12 other terms	28	$108	$108	$8	7%	—	$98 – $136
21	Tricare facility · fee schedule · outpatient · +12 other terms	28	$97	$87	$20	22%	—	$17 – $158
22	Baylor Scott White Health Plan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	26	$116	$91	$18	20%	—	$66 – $126
23	Highmark facility · fee schedule · outpatient · +9 other terms	26	$169	$169	$108	64%	—	$48 – $706
24	Regence facility · fee schedule · outpatient · +12 other terms	22	$102	$106	$10	10%	—	$90 – $125
25	First Health fee schedule · outpatient · +15 other terms	21	$92	$111	$73	66%	—	$21 – $448

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