go back

Kansas 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
$1,701.35 / $1,701.35 / $1,701.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$594.04 / $1,114.67 / $1,701.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,474.01 / $1,608.22 / $1,705.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,596.29 / $1,596.29 / $1,596.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,335.63 / $1,335.63 / $1,335.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$975.01 / $1,335.63 / $2,992.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$594.04 / $1,655.80 / $9,614.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$613.45 / $1,025.00 / $1,967.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$623.13 / $1,025.00 / $1,372.79