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Arizona 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
$72.44 / $72.44 / $72.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $72.44 / $239.88
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $128.82 / $169.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.65 / $104.71 / $208.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $165.96 / $316.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.10 / $87.10 / $87.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $63.10 / $87.10
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $112.20 / $676.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $61.66 / $870.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.77 / $75.86 / $131.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $61.66 / $93.33