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Tennessee 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
$50.98 / $50.98 / $55.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.50 / $51.92 / $95.41
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.98 / $84.98 / $137.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.51 / $101.98 / $101.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.57 / $70.80 / $74.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.68 / $51.68 / $70.80
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$188.81 / $589.07 / $636.98
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$736.54 / $736.54 / $869.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.68 / $56.02 / $81.09