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New Hampshire 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

Facilitymedian $1,288 · 10th–90th $708–$1,5140%20%40%10th90th$1,288Professionalmedian $813 · 10th–90th $550–$1,1480%20%10th90th$813$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $851.14
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $707.95 / $1,096.48
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,380.38 / $1,584.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $776.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $724.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $724.44
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $2,041.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $575.44 / $758.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $758.58 / $1,096.48
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,819.70