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Vermont rates for HCPCS L3961

Shoulder Elbow Wrist Hand Orthosis Shoulder Cap Design Without Joints May Include Soft Interface Straps Custom Fabricated Includes Fitting And Adjustment

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$877.47 / $877.47 / $1,012.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,028.38 / $1,028.38 / $1,028.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$750.72 / $750.72 / $750.72
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,028.38 / $1,028.38 / $1,028.38
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$750.72 / $750.72 / $750.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$598.04 / $1,065.16 / $2,078.73