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Oklahoma 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
$1,034.00 / $1,034.00 / $1,523.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$995.70 / $1,034.00 / $1,165.66
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 / $1,540.39 / $1,540.39
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$625.83 / $1,313.37 / $10,128.96
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$646.26 / $1,042.31 / $2,162.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$646.26 / $986.02 / $1,390.73