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Mississippi 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
$1,230.27 / $1,230.27 / $1,949.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,174.90 / $1,949.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $1,698.24 / $1,698.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $1,698.24 / $1,698.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.82 / $1,548.82 / $1,548.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,122.02 / $1,548.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $1,737.80 / $2,630.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $1,047.13 / $1,479.11