go back

South Carolina 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
$449.77 / $449.77 / $449.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$401.27 / $449.77 / $795.72
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$590.67 / $590.67 / $590.67
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$526.00 / $663.14 / $963.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$404.72 / $510.00 / $563.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$372.30 / $510.00 / $546.48
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.96 / $651.00 / $1,427.17
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$511.00 / $511.00 / $549.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$614.06 / $614.06 / $614.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.24 / $433.15 / $546.48