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Hawaii 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
Professional
Modifier
Low / Median / High Price
$328.31 / $328.31 / $328.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$766.12 / $766.12 / $766.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$551.53 / $551.53 / $1,060.83
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$964.39 / $1,009.83 / $1,009.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$578.63 / $964.39 / $1,350.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$672.08 / $766.12 / $1,060.83
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$672.08 / $803.47 / $917.92