go back

West Virginia 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
$416.87 / $416.87 / $416.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $436.52 / $812.83
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $588.84 / $1,230.27
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $630.96 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $1,445.44 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $371.54 / $4,365.16
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $562.34 / $562.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $537.03 / $933.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $457.09 / $676.08