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Colorado rates for HCPCS L3976

Shoulder-elbow-wrist-hand-finger orthosis (SEWHO), abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,043.01 / $1,043.01 / $1,043.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$782.51 / $1,043.01 / $1,394.72
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.51 / $2,092.71 / $3,799.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,002.36 / $1,002.36 / $1,082.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,028.38 / $1,028.38 / $1,028.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$750.72 / $750.72 / $1,961.65
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$530.05 / $1,015.87 / $2,474.91
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$530.05 / $530.05 / $530.05
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,359.63 / $2,328.14 / $3,687.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$745.52 / $821.06 / $1,236.82