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California rates for HCPCS L3671

Shoulder orthosis (SO), shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $524.81 / $4,168.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $524.81 / $2,691.53
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $512.86 / $2,187.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $501.19 / $1,071.52
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $1,698.24 / $2,238.72
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,819.70 / $3,090.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $549.54 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $398.11 / $549.54
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $645.65 / $1,174.90
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $891.25 / $1,548.82
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,570.88 / $4,570.88 / $4,570.88
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,011.87 / $7,244.36 / $7,244.36
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,000.00 / $1,000.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.84 / $977.24 / $1,230.27
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $398.11 / $933.25
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $1,819.70 / $1,819.70
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $776.25 / $891.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.44 / $436.52 / $1,202.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $478.63 / $977.24