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Washington, DC rates for HCPCS L3971

Shoulder-elbow-wrist-hand orthotic (SEWHO), shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$824.80 / $824.80 / $824.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$824.80 / $824.80 / $824.80
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,225.98 / $1,225.98 / $1,377.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$975.01 / $975.01 / $975.01
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,309.90 / $1,309.90 / $4,000.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$670.25 / $907.76 / $1,510.58