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Kentucky 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
$899.78 / $1,066.95 / $1,106.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$916.63 / $1,066.95 / $1,108.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,292.22 / $2,075.85 / $2,181.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$970.92 / $1,080.08 / $1,123.35
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,556.89 / $2,890.59 / $3,325.13
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,972.06 / $2,580.89 / $3,425.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,335.63 / $1,335.63 / $2,432.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$975.01 / $1,335.63 / $9,902.29
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.63 / $1,248.33 / $1,560.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$690.42 / $996.86 / $1,368.51