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Kentucky rates for HCPCS L3962

Shoulder-elbow-wrist-hand orthosis (SEWHO), abduction positioning, Erb's palsy design, prefabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$287.52 / $486.32 / $504.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$376.44 / $424.84 / $504.34
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$589.01 / $946.20 / $994.46
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$385.87 / $463.19 / $481.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$709.65 / $1,146.92 / $1,371.99
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$898.89 / $1,135.44 / $1,561.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$494.25 / $494.25 / $1,108.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.80 / $494.25 / $4,278.52
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$494.49 / $603.04 / $753.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.05 / $426.65 / $623.78