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Wyoming 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
Professional
Modifier
Low / Median / High Price
$1,043.01 / $1,043.01 / $1,630.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,818.86 / $1,818.86 / $1,818.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,818.86 / $1,818.86 / $1,818.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,028.38 / $1,028.38 / $2,016.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$750.72 / $750.72 / $1,028.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$742.09 / $821.06 / $911.54