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North Dakota rates for HCPCS L3674

Shoulder orthosis (SO), abduction positioning (airplane design), 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
Facility
Modifier
Low / Median / High Price
$953.37 / $953.37 / $953.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$900.59 / $900.59 / $953.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,225.22 / $1,448.64 / $1,484.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,502.63 / $1,517.65 / $1,908.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$873.50 / $1,012.06 / $6,035.75
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$522.04 / $653.74 / $1,059.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$385.10 / $641.30 / $1,044.08