go back

Alabama rates for HCPCS L3677

Shoulder Orthosis Shoulder Joint Design Without Joints May Include Soft Interface Straps Pre- Fabricated Item That Has Been Trimmed Bent Molded Assembled Or Otherwise Customized To Fit A Specific Patient By An Individual With Expertise(Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.51 / $84.51 / $84.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.50 / $84.51 / $84.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.05 / $75.05 / $75.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.79 / $54.79 / $101.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.54 / $55.19 / $100.99