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Wisconsin rates for HCPCS L3670

Shoulder orthosis (SO), acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf

Facilitymedian $126 · 10th–90th $76$2140%20%40%10th90th$126Professionalmedian $89 · 10th–90th $54$2190%10%10th90th$89$0.1$0.5$2.0$10.0$50.0$200.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $128.82 / $213.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $69.18 / $169.82
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $208.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $141.25
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $251.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $295.12 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $181.97 / $239.88
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $104.71 / $158.49
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $204.17 / $257.04
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $123.03 / $676.08
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $75.86 / $158.49
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $70.79 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $144.54 / $251.19
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $194.98 / $389.05
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $251.19 / $794.33
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $125.89 / $891.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $72.44 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $120.23 / $281.84