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Utah 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
$478.11 / $478.11 / $478.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.11 / $478.11 / $3,650.06
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
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.10 / $956.62 / $1,243.60
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,147.42 / $1,279.68 / $1,279.68
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$728.69 / $917.27 / $1,375.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$452.30 / $577.66 / $694.73