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New Hampshire rates for HCPCS L3670

Shoulder Orthosis Acromio/Clavicular (Canvas And Webbing Type) Prefabricated Off-The-Shelf (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.22 / $44.78 / $53.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.78 / $61.62 / $221.22
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.50 / $93.50 / $124.66
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$124.66 / $124.66 / $147.77
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.20 / $83.38 / $83.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.64 / $86.64 / $91.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.25 / $63.25 / $91.83
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.93 / $100.93 / $311.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.46 / $62.19 / $73.84
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.45 / $97.74 / $143.68