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Nevada 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
$725.00 / $725.00 / $836.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$725.00 / $836.54 / $1,117.97
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,123.00 / $2,123.00 / $2,123.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,137.90 / $1,181.67 / $2,590.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,540.39 / $1,540.39 / $1,562.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,124.48 / $1,376.83 / $1,586.60
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,180.57 / $1,698.40 / $2,759.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$759.03 / $969.40 / $1,418.53