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West Virginia 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
$653.57 / $653.57 / $653.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$609.26 / $625.51 / $653.57
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$847.06 / $1,707.84 / $2,213.87
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$822.30 / $912.22 / $1,563.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$723.52 / $723.52 / $1,527.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$528.16 / $723.52 / $6,216.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$521.57 / $664.84 / $1,234.70