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Maine 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
$416.87 / $524.81 / $1,479.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $1,148.15 / $1,318.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $501.19 / $707.95
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $851.14 / $1,000.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $575.44 / $1,479.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.84 / $436.52 / $436.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $537.03 / $933.25