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New Hampshire 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
$40.51 / $163.53 / $202.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.59 / $46.63 / $66.01
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.31 / $113.31 / $113.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.08 / $151.08 / $179.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.83 / $71.83 / $72.69
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 / $70.80
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.32 / $122.32 / $377.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.25 / $75.37 / $89.50
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.70 / $118.44 / $174.11