go back

New Hampshire 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
Facility
Modifier
Low / Median / High Price
$712.33 / $712.33 / $854.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$520.64 / $552.74 / $712.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,265.07 / $1,265.07 / $1,499.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$712.33 / $752.32 / $752.32
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 / $528.16 / $723.52
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,024.28 / $1,024.28 / $3,161.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$420.76 / $631.13 / $807.30
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$947.50 / $1,042.25 / $1,326.50