go back

Missouri 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
$464.88 / $464.88 / $619.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$449.51 / $481.78 / $735.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$888.02 / $932.42 / $4,099.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$432.55 / $492.70 / $718.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$510.00 / $510.00 / $516.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$372.30 / $372.30 / $543.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$451.70 / $718.77 / $4,248.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$334.88 / $443.02 / $1,079.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$334.88 / $443.02 / $656.74