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Rhode Island 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
$21.69 / $39.27 / $48.06
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.58 / $154.74 / $183.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.99 / $52.93 / $73.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.70 / $46.87 / $69.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.00 / $34.09 / $69.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.18 / $87.18 / $87.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.61 / $40.43 / $67.38