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New Mexico 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 $4,677 · 10th–90th $759–$15,4880%5%10th90th$4,677Professionalmedian $933 · 10th–90th $759–$1,6600%20%10th90th$933$100.0$500.0$2.0K$10.0K$50.0K

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
$912.01 / $912.01 / $912.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $933.25 / $1,380.38
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $9,772.37 / $16,218.10
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 / $2,238.72
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,862.09 / $2,754.23
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $1,258.93 / $1,905.46
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,862.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $891.25 / $2,238.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $812.83 / $1,230.27