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Rhode Island 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
Professional
Modifier
Low / Median / High Price
$460.81 / $475.06 / $625.51
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,491.11 / $2,013.96 / $2,384.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$688.85 / $688.85 / $953.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$494.25 / $494.25 / $610.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.80 / $494.25 / $494.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$350.77 / $526.15 / $876.92