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Vermont 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
$36.31 / $64.57 / $91.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $123.03 / $123.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.79 / $70.79 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $51.29 / $75.86
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $117.49 / $151.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $56.23 / $70.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $89.13 / $316.23