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Oklahoma 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
Facility
Modifier
Low / Median / High Price
$33.88 / $83.67 / $233.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.61 / $33.88 / $39.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.74 / $62.74 / $62.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.70 / $46.70 / $69.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.46 / $34.09 / $69.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.06 / $44.42 / $352.17
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.75 / $34.25 / $70.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.09 / $74.09 / $74.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.75 / $32.61 / $46.79