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Missouri 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
$62.67 / $62.67 / $85.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.59 / $76.98 / $117.51
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.27 / $68.95 / $68.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.91 / $149.01 / $655.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.55 / $71.83 / $114.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.80 / $70.80 / $74.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.68 / $51.68 / $51.68
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.98 / $113.31 / $589.07
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.20 / $70.79 / $172.49
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.25 / $104.25 / $104.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.20 / $69.44 / $120.86