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Vermont rates for HCPCS L3960

Shoulder-elbow-wrist-hand orthosis (SEWHO), abduction positioning, airplane design, prefabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$268.77 / $469.76 / $542.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$778.80 / $778.80 / $778.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$510.00 / $510.00 / $707.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$372.30 / $510.00 / $543.69
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$510.00 / $510.00 / $707.52
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$372.30 / $510.00 / $543.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.16 / $570.23 / $1,112.83