Prefabricated hand finger splint 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-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HB-Hfo (Comfort Cool, Benik), Ots

Payers reporting HCPCS L3924

Payer pricing summary

Low

$12

Average

$109

Median

$95

High

$676

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +23 other terms	387	$99	$108	$39	36%	—	$1 – $389
2	Aetna fee schedule · outpatient · +24 other terms	377	$99	$116	$56	49%	—	$1 – $719
3	Humana fee schedule · outpatient · +23 other terms	333	$98	$145	$153	105%	—	$1 – $752
4	Blue Cross Blue Shield fee schedule · outpatient · +19 other terms	219	$100	$124	$64	51%	—	$0 – $493
5	WellCare fee schedule · outpatient · +11 other terms	215	$101	$104	$19	18%	—	$11 – $191
6	Devoted fee schedule · outpatient · +9 other terms	162	$98	$98	$3	3%	—	$94 – $133
7	Molina fee schedule · outpatient · +15 other terms	145	$139	$136	$52	38%	—	$1 – $256
8	Cigna Healthspring fee schedule · outpatient · +6 other terms	116	$101	$100	$5	5%	—	$98 – $134
9	Cigna fee schedule · outpatient · +20 other terms	109	$101	$126	$53	42%	—	$44 – $402
10	Anthem fee schedule · outpatient · +23 other terms	88	$98	$143	$146	102%	—	$11 – $810
11	Kaiser fee schedule · outpatient · +15 other terms	69	$100	$171	$123	72%	—	$86 – $789
12	Caresource fee schedule · outpatient · +9 other terms	43	$98	$105	$18	17%	—	$1 – $167
13	Ambetter facility · fee schedule · outpatient · +12 other terms	41	$165	$181	$51	28%	—	$0 – $275
14	Superior Healthplan fee schedule · outpatient · +2 other terms	40	$103	$103	$0	0%	—	$96 – $103
15	Optum fee schedule · outpatient · +13 other terms	38	$98	$122	$51	42%	—	$26 – $245
16	Clover fee schedule · outpatient · +3 other terms	37	$98	$100	$6	6%	—	$96 – $130
17	Oscar fee schedule · outpatient · +12 other terms	36	$103	$114	$25	22%	—	$96 – $170
18	Medica facility · fee schedule · outpatient · +12 other terms	21	$81	$81	$36	45%	—	$4 – $136
19	Medicare fee schedule · outpatient · +7 other terms	19	$94	$94	$1	1%	—	$94 – $98
20	Regence facility · fee schedule · outpatient · +7 other terms	19	$102	$101	$4	4%	—	$90 – $104
21	Amerihealth Caritas fee schedule · outpatient · +6 other terms	18	$117	$115	$4	3%	—	$107 – $117
22	Bcbs Tx fee schedule · outpatient · +3 other terms	18	$96	$96	—	—	—	$96 – $96
23	Tricare fee schedule · both · +9 other terms	16	$95	$96	$2	2%	—	$93 – $98
24	Medical Mutual facility · fee schedule · outpatient · +5 other terms	15	$108	$125	$31	25%	—	$59 – $171
25	Bcbs Mn fee schedule · outpatient · +7 other terms	13	$98	$98	$21	21%	—	$48 – $115

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