go back

Indiana 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
Facility
Modifier
Low / Median / High Price
$56.08 / $170.02 / $196.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.59 / $58.24 / $63.01
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.56 / $84.98 / $84.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.51 / $101.41 / $113.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.28 / $71.83 / $99.12
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.31 / $124.64 / $169.97
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.31 / $135.97 / $158.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.80 / $70.80 / $113.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.68 / $51.68 / $116.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.68 / $56.53 / $83.47