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Alabama rates for HCPCS L3675

Shoulder Orthosis Vest Type Abduction Restrainer Canvas Webbing Type Or Equal Prefabricated Off- The-Shelf (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$174.49 / $174.49 / $174.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.13 / $174.49 / $174.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.80 / $112.80 / $112.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.42 / $107.42 / $192.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.42 / $107.42 / $168.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.45 / $85.00 / $102.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.18 / $85.76 / $136.93