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Maine rates for HCPCS L3971

Shoulder Elbow Wrist Hand Orthosis 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
Professional
Modifier
Low / Median / High Price
$963.30 / $1,223.21 / $1,223.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,792.35 / $2,322.15 / $4,304.53
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,123.35 / $1,177.02 / $1,177.02
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 / $975.01 / $1,335.63
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,631.65 / $1,631.65 / $1,631.65
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,134.71 / $1,223.21 / $1,223.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$708.98 / $1,313.46 / $2,232.33