go back

Arkansas rates for HCPCS L3962

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$439.65 / $439.65 / $439.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$344.22 / $439.65 / $439.65
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$682.84 / $903.75 / $1,004.17
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$790.98 / $790.98 / $946.20
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$790.98 / $790.98 / $790.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$494.25 / $494.25 / $632.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.80 / $494.25 / $617.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.08 / $391.09 / $531.98