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Idaho rates for HCPCS L3650

Shoulder Orthosis Figure Of Eight Design Abduction Restrainer Prefabricated Off-The-Shelf(Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.35 / $47.04 / $61.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.70 / $46.70 / $54.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.09 / $46.70 / $49.79
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.06 / $52.31 / $69.69
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.72 / $66.20 / $69.69
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $51.43 / $61.25
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.03 / $68.06 / $102.09
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.78 / $48.78 / $73.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.16 / $32.61 / $50.26