go back

Wyoming 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
Professional
Modifier
Low / Median / High Price
$1,168.90 / $1,168.90 / $1,827.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,038.40 / $2,038.40 / $2,038.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,038.40 / $2,038.40 / $2,038.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,335.63 / $1,335.63 / $2,260.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$975.01 / $975.01 / $1,335.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.67 / $920.18 / $1,021.58