go back

Rhode Island 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
Professional
Modifier
Low / Median / High Price
$552.74 / $695.43 / $750.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,788.63 / $2,415.78 / $2,860.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$726.57 / $854.79 / $1,144.02
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 / $723.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.58 / $712.12 / $1,051.89