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Tennessee 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
$12.10 / $17.60 / $374.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.14 / $71.05 / $138.28
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.55 / $150.00 / $273.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.10 / $142.13 / $142.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.64 / $86.64 / $91.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.25 / $63.25 / $86.64
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$236.02 / $670.88 / $789.50
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$868.37 / $889.20 / $1,108.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.83 / $73.43 / $93.69