go back

New Jersey 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
$686.05 / $686.05 / $686.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$686.05 / $876.99 / $1,108.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,335.63 / $1,335.63 / $2,015.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$975.01 / $975.01 / $1,764.61
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,841.06 / $1,854.01 / $2,639.95
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,918.13 / $2,015.23 / $2,015.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$835.51 / $1,005.38 / $2,015.23