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Arizona rates for HCPCS L3961

Shoulder-elbow-wrist-hand orthosis (SEWHO), shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Facilitymedian $1,479 · 10th–90th $490–$3,4670%10%10th90th$1,479Professionalmedian $955 · 10th–90th $759–$1,6600%20%40%10th90th$955$2.0$10.0$50.0$200.0$1.0K$5.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $954.99 / $1,659.59
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $1,778.28 / $3,311.31
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,621.81 / $3,162.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,023.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,023.29
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $1,202.26 / $8,511.38
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $812.83 / $9,332.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $1,479.11 / $1,479.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $812.83 / $1,230.27