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California rates for HCPCS L3962

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

Facilitymedian $457 · 10th–90th $363–$2,0890%20%10th90th$457Professionalmedian $479 · 10th–90th $363–$4,0740%20%10th90th$479$1.0$5.0$20.0$100.0$500.0$2.0K$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $478.63 / $4,073.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $457.09 / $2,089.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $478.63 / $1,288.25
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $1,548.82 / $2,454.71
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,949.84 / $3,981.07
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $489.78
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $501.19 / $1,288.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $912.01 / $1,659.59
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,128.61 / $5,888.44 / $5,888.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $851.14 / $1,288.25
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $954.99
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $512.86 / $977.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $389.05 / $1,071.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $478.63 / $1,096.48