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Nebraska 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
$90.50 / $90.50 / $279.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.46 / $90.50 / $115.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.43 / $120.62 / $120.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.72 / $137.19 / $138.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.80 / $156.10 / $156.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.25 / $156.10 / $240.70
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.09 / $153.85 / $589.07
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.20 / $70.79 / $117.99
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.65 / $156.10 / $196.68
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.07 / $182.34 / $321.58
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.03 / $169.36 / $295.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.20 / $67.25 / $90.64