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Alaska rates for HCPCS L3660

Shoulder orthosis (SO), figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.50 / $114.35 / $150.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.80 / $70.80 / $70.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.68 / $51.68 / $51.68
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.50 / $36.50 / $36.50
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.64 / $126.82 / $200.24
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.50 / $36.50 / $70.80
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.68 / $84.03 / $156.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.52 / $127.65 / $166.50