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Idaho rates for HCPCS L3960

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$425.66 / $607.66 / $797.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$510.00 / $510.00 / $677.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$372.30 / $510.00 / $543.69
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$260.95 / $683.95 / $911.03
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$819.93 / $865.48 / $911.03
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $672.34 / $800.71
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$797.73 / $889.68 / $1,334.52
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$637.72 / $637.72 / $956.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$373.72 / $404.20 / $641.05