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South Carolina rates for HCPCS L3981

Upper Extremity Fracture Orthosis Humeral Prefabricated Includes Shoulder Cap Design With Or Without Joints Forearm Section May Include Soft Interface Straps Includes Fitting And Adjustments

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.24 / $549.24 / $549.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$526.99 / $549.24 / $971.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,109.71 / $1,109.71 / $1,335.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.27 / $616.27 / $680.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$449.88 / $616.27 / $616.27
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.24 / $768.94 / $1,795.61
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$881.56 / $881.56 / $881.56
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$749.86 / $749.86 / $749.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$369.08 / $528.94 / $783.48