go back

Nebraska rates for HCPCS L3999

Upper limb orthosis, not otherwise specified

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.40 / $9.40 / $9.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.40 / $14.40 / $14.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.92 / $34.92 / $34.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $34.92 / $50.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $112.62 / $112.62
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.06 / $120.06 / $120.06