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Hawaii 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 $1,023 · 10th–90th $813–$1,4130%20%40%10th90th$1,023Professionalmedian $1,072 · 10th–90th $776–$1,9050%20%10th90th$1,072$1.0K$2.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $954.99 / $1,288.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,412.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,698.24 / $2,238.72
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $1,905.46
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,819.70 / $2,089.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $831.76 / $1,023.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,258.93 / $1,995.26