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Maine 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 $2,089 · 10th–90th $1,023$2,4550%20%10th90th$2,089Professionalmedian $1,047 · 10th–90th $776$1,9050%20%10th90th$1,047$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$1,023.29
Typical High
$2,754.23
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,778.28
Median
$2,137.96
Typical High
$2,454.71
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$1,318.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$1,023.29
Typical High
$1,023.29
Cigna
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$1,023.29
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$1,584.89
Median
$1,584.89
Typical High
$1,905.46
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$1,047.13
Typical High
$1,122.02
United
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$812.83
Typical High
$812.83
United
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,548.82
Typical High
$1,584.89