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Wyoming 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
$426.58 / $933.25 / $1,288.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $794.33 / $794.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $794.33 / $794.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $512.86 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $371.54 / $812.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $398.11 / $645.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $407.38 / $602.56