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Kentucky 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
$294.50 / $467.07 / $484.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$294.50 / $467.07 / $535.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$565.69 / $908.74 / $955.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$425.04 / $426.64 / $492.70
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$681.56 / $1,224.38 / $1,399.30
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$863.30 / $1,093.20 / $1,499.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$510.00 / $510.00 / $1,064.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$372.30 / $510.00 / $1,595.80
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.90 / $579.15 / $723.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.24 / $436.31 / $599.09