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New Jersey 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
$282.92 / $282.92 / $282.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$282.92 / $383.44 / $523.94
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$755.00 / $755.00 / $755.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$510.00 / $510.00 / $831.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$372.30 / $372.30 / $727.69
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$759.23 / $764.57 / $1,088.68
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$811.57 / $831.05 / $831.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.01 / $414.60 / $762.95