go back

North Dakota 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
$589.46 / $589.46 / $589.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$486.62 / $486.62 / $607.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$757.54 / $895.68 / $917.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,014.00 / $1,024.14 / $1,287.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$451.70 / $607.66 / $4,248.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$322.77 / $429.03 / $673.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.47 / $404.20 / $673.67