HCPCS L3904

Wrist hand finger orthosis, external powered, electric, custom fabricated

Current code23 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

Prices for HCPCS L3904 by hospital
HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$2,837 – $22,01816 plans——
Deaconess Medical CenterSpokaneFile dated 2026-08-27$3,941 – $13,7059 plans——
Harborview Medical CenterSeattleFile dated 2026-04-01$5,269 – $6,5862 plans$4,034$5,763
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01$4,966 – $9,2505 plans——
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$2,837 – $24,1687 plans——
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$2,759 – $14,22717 plans——
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$2,759 – $14,22717 plans——
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$3,201 – $14,22712 plans——
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$3,153 – $13,67410 plans——
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$3,020 – $9,06010 plans——
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$5,100 – $10,9249 plans——
Providence Centralia HospitalCentraliaFile dated 2026-04-01$5,565 – $12,3125 plans——
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$3,952 – $7,6407 plans——
Providence St Peter HospitalOlympiaFile dated 2026-04-01$2,799 – $10,7528 plans——
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$4,939 – $12,0807 plans——
Swedish IssaquahIssaquahFile dated 2026-04-01$4,939 – $7,3107 plans——
Swedish Medical CenterSeattleFile dated 2026-04-01$4,939 – $11,7629 plans——
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$4,939 – $11,7629 plans——
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$2,759 – $14,22717 plans——
University of Washington Medical CtrSeattleFile dated 2026-04-01$5,269 – $10,3275 plans——
Virginia Mason Medical CenterSeattle$3,153 – $11,4527 plans——
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27$8,3101 plan——
Yakima Valley MemorialYakimaFile dated 2026-08-27$2,837 – $8,54213 plans——

Lowest and highest amounts each hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Equipment fee, Washington
$3,293 (fee)