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Connecticut rates for HCPCS L3960

Shoulder-elbow-wrist-hand orthosis (SEWHO), abduction positioning, airplane design, prefabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $467.74 / $467.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $467.74 / $1,148.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $977.24 / $1,174.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $512.86 / $691.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $512.86 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $371.54 / $371.54
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $630.96 / $630.96
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $691.83 / $933.25
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $575.44 / $1,148.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $398.11 / $562.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $478.63 / $645.65