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Nebraska 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
$25.70 / $151.36 / $2,511.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $104.71 / $302.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $125.89 / $269.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $162.18 / $162.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.10 / $91.20 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $181.97 / $281.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $181.97 / $676.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $83.18 / $194.98
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $181.97 / $416.87
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $186.21 / $186.21
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $416.87 / $416.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.86 / $74.13 / $144.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $74.13 / $125.89