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Maine 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
$263.03 / $263.03 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $69.18 / $234.42
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$147.91 / $177.83 / $204.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $72.44 / $89.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.79 / $70.79 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $51.29 / $70.79
Community Health Options
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $128.82 / $144.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $131.83 / $158.49
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $263.03 / $263.03
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $72.44 / $234.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.31 / $56.23 / $67.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $75.86 / $131.83