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South Carolina 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 $1,122 · 10th–90th $851–$2,3440%20%10th90th$1,122Professionalmedian $955 · 10th–90th $776–$1,6220%20%10th90th$955$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
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $912.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $954.99 / $1,621.81
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,995.26 / $2,344.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $2,137.96
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $933.25
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $1,348.96 / $2,951.21
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $1,258.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $1,023.29 / $2,238.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $912.01 / $1,230.27