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Washington rates for HCPCS L3960

Shoulder-elbow-wrist-hand orthosis (SEWHO), abduction positioning, airplane design, prefabricated, includes fitting and adjustment

Facilitymedian $912 · 10th–90th $617$2,0890%20%10th90th$912Professionalmedian $617 · 10th–90th $407$1,2880%20%10th90th$617$1.0$5.0$20.0$100.0$500.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $1,445.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $537.03 / $1,258.93
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $891.25 / $891.25
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $1,023.29
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $512.86
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $1,202.26 / $2,570.40
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $1,071.52 / $1,862.09
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $691.83 / $776.25
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $891.25 / $912.01
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $912.01
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $1,348.96 / $1,819.70
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $891.25
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $891.25
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $1,023.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $1,096.48 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $467.74 / $776.25
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $645.65 / $1,380.38