go back

Indiana 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
$16.50 / $18.53 / $157.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.14 / $66.95 / $141.19
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.12 / $93.50 / $157.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$98.48 / $111.57 / $124.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.82 / $83.38 / $115.06
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$124.66 / $149.59 / $186.99
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.66 / $149.59 / $186.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.64 / $86.64 / $124.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.25 / $86.64 / $127.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.46 / $62.19 / $91.05