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Alaska rates for HCPCS L3670

Shoulder orthosis (SO), acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.40 / $118.81 / $118.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.14 / $169.27 / $223.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.64 / $86.64 / $86.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.25 / $86.64 / $92.36
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.15 / $40.15 / $40.15
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.11 / $187.72 / $296.39
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.15 / $40.15 / $86.64
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.25 / $92.36 / $151.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $188.95 / $246.45