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Florida rates for HCPCS L3967

Shoulder-elbow-wrist-hand orthosis (SEWHO), abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$906.08 / $1,004.13 / $1,150.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$868.90 / $1,056.98 / $1,914.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,540.39 / $1,540.39 / $1,540.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,124.48 / $1,124.48 / $1,540.39
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99,999.99 / $99,999.99 / $99,999.99
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$986.09 / $1,578.69 / $2,186.92
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,749.53 / $1,749.53 / $1,749.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$875.28 / $1,081.30 / $1,390.73
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,181.67 / $1,181.67 / $2,186.92