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Alabama rates for HCPCS L3975

Shoulder-elbow-wrist-hand-finger orthosis (SEWHO), shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,670.58 / $1,670.58 / $1,670.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$790.80 / $1,670.58 / $1,670.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,378.63 / $1,378.63 / $1,378.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,191.78 / $1,191.78 / $1,842.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.00 / $1,191.78 / $1,763.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$547.38 / $821.06 / $1,261.35