Custom hand and finger brace with elastic bands at Mayo Clinic Arizona

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

HC ORTHOSIS HAND W JTS CUSTOM

Phoenix, AZ

See all payers reporting HCPCS L3921 →

Payers reporting HCPCS L3921 at Mayo Clinic Arizona

Negotiated rates from the hospital’s own file: 17 payers, 86 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Medica az uhc optum [72] facility · percent of total billed charges · bothfrom % of charges	$187	$187	—	—	—	$187 – $187
2	Optum az uhc optum [72] facility · percent of total billed charges · bothfrom % of charges	$187	$187	—	—	—	$187 – $187
3	UnitedHealthcare az uhc gap exception [1376] facility · percent of total billed charges · bothfrom % of charges	$187	$187	—	—	—	$187 – $187
4	UnitedHealthcare az uhc optum [72] facility · percent of total billed charges · bothfrom % of charges	$187	$187	—	—	—	$187 – $187
5	Cigna az cigna [39] facility · percent of total billed charges · bothfrom % of charges	$191	$191	—	—	—	$191 – $191
6	Cigna az cigna gap exception [1383] facility · percent of total billed charges · bothfrom % of charges	$191	$191	—	—	—	$191 – $191
7	Healthpartners az cigna [39] facility · percent of total billed charges · bothfrom % of charges	$191	$191	—	—	—	$191 – $191
8	Humana az cigna [39] facility · percent of total billed charges · bothfrom % of charges	$191	$191	—	—	—	$191 – $191
9	Medcost az cigna [39] facility · percent of total billed charges · bothfrom % of charges	$191	$191	—	—	—	$191 – $191
10	Medical Mutual az cigna [39] facility · percent of total billed charges · bothfrom % of charges	$191	$191	—	—	—	$191 – $191
11	Oscar az cigna [39] facility · percent of total billed charges · bothfrom % of charges	$191	$191	—	—	—	$191 – $191
12	Aetna az aetna [26] facility · percent of total billed charges · bothfrom % of charges	$208	$208	—	—	—	$208 – $208
13	Anthem az bcbs [124] facility · percent of total billed charges · bothfrom % of charges	$208	$208	—	—	—	$208 – $208
14	Blue Cross Blue Shield az bcbs [124] facility · percent of total billed charges · bothfrom % of charges	$208	$208	—	—	—	$208 – $208
15	Blue Cross Blue Shield az federal retiree [1020] facility · percent of total billed charges · bothfrom % of charges	$208	$208	—	—	—	$208 – $208
16	Blue Cross Blue Shield az tx bcbs [875] facility · percent of total billed charges · bothfrom % of charges	$208	$208	—	—	—	$208 – $208
17	Cigna az tx cigna [838] facility · percent of total billed charges · bothfrom % of charges	$208	$208	—	—	—	$208 – $208
18	Healthpartners az cc complex care [768] facility · percent of total billed charges · bothfrom % of charges	$208	$208	—	—	—	$208 – $208
19	Kaiser az fl transplant [694] facility · percent of total billed charges · bothfrom % of charges	$208	$208	—	—	—	$208 – $208
20	Medical Mutual az aetna [26] facility · percent of total billed charges · bothfrom % of charges	$208	$208	—	—	—	$208 – $208
21	Aetna az geha aetna federal retiree [1021] facility · percent of total billed charges · bothfrom % of charges	$222	$222	—	—	—	$222 – $222
22	Humana az by plan [32] facility · percent of total billed charges · bothfrom % of charges	$222	$222	—	—	—	$222 – $222
23	Optum az veteran affairs optum [1051] facility · percent of total billed charges · bothfrom % of charges	$222	$222	—	—	—	$222 – $222
24	Medica az uhc optum [36] professional · percent of total billed charges · outpatientfrom % of charges	$238	$238	—	—	—	$238 – $238
25	Optum az uhc optum [36] professional · percent of total billed charges · outpatientfrom % of charges	$238	$238	—	—	—	$238 – $238

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