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Louisiana 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
$1,121.83 / $1,190.86 / $1,604.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$985.81 / $1,190.86 / $1,294.43
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,806.67 / $3,086.43 / $4,338.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,232.08 / $1,473.75 / $1,473.75
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
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 / $1,335.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$613.45 / $957.44 / $1,459.40