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Rhode Island 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
$56.23 / $56.23 / $56.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $91.20 / $223.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.97 / $245.47 / $288.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $81.28 / $131.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.44 / $72.44 / $91.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $63.10 / $87.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $75.86 / $169.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $72.44 / $104.71