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Nevada 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
$614.05 / $614.05 / $708.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$614.05 / $708.53 / $767.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,798.13 / $1,798.13 / $1,798.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$963.75 / $1,002.36 / $2,194.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,191.78 / $1,191.78 / $1,323.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.00 / $1,166.18 / $1,227.53
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$999.92 / $1,438.50 / $2,337.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$642.88 / $821.06 / $1,368.44