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Alaska rates for HCPCS L3962

Shoulder-elbow-wrist-hand orthosis (SEWHO), abduction positioning, Erb's palsy design, prefabricated, includes fitting and adjustment

Facilitymedian $490 · 10th–90th $257–$1,0720%20%40%10th90th$490Professionalmedian $575 · 10th–90th $447–$1,4790%20%10th90th$575$100.0$200.0$500.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $549.54 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $1,258.93
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $812.83 / $1,047.13
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $1,047.13 / $3,019.95
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $1,047.13 / $1,096.48
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,047.13 / $1,096.48
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $1,071.52
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $489.78 / $933.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $446.68
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $602.56 / $2,691.53