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Kentucky 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 $794–$2,9510%20%10th90th$1,023Professionalmedian $955 · 10th–90th $794–$1,2880%20%40%10th90th$955$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$954.99 / $954.99 / $977.24
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $954.99 / $1,288.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,905.46 / $1,995.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $954.99 / $1,000.00
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,511.89 / $3,235.94
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,290.87 / $2,951.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $2,951.21 / $2,951.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,479.11 / $8,912.51
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $812.83 / $1,071.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $891.25 / $1,230.27