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Idaho rates for HCPCS L3674

Shoulder Orthosis Abduction Positioning (Airplanedesign) Thoracic Component And Support Bar With Or Without Nontorsion Joint/Turnbuckle May Include Soft Interface Straps Custom Fabricated Includes Fitting And Adjustment

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.48 / $1,107.74 / $1,107.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$723.52 / $723.52 / $723.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$528.16 / $723.52 / $745.23
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$848.06 / $906.65 / $1,265.07
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,138.56 / $1,201.82 / $1,265.07
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $945.10 / $1,138.56
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,107.74 / $1,235.42 / $1,853.13
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$885.55 / $917.27 / $1,328.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$534.09 / $577.66 / $1,584.22