go back

Montana 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 / $36.50 / $68.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.43 / $144.43 / $144.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.80 / $155.30 / $155.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.80 / $155.30 / $155.30
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.18 / $147.90 / $155.30
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.85 / $116.55 / $155.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.09 / $56.53 / $86.50