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SEWHO, Abduction Positioning, Erb's Palsy, Prefabricated

Idaho rates for HCPCS L3962

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

Rates data updated July 2026.

Facilitymedian $871 · 10th–90th $447$1,2300%20%40%10th90th$871Professionalmedian $661 · 10th–90th $324$1,0960%10%20%10th90th$661$1.0$5.0$20.0$100.0$500.0$2.0K

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
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$575.44
Typical High
$870.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$933.25
Typical High
$1,584.89
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,096.48
Typical High
$1,096.48
Cigna
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$660.69
Cigna
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$489.78
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$812.83
Typical High
$1,071.52
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$954.99
Typical High
$1,000.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$851.14
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$954.99
Typical High
$954.99
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$1,096.48
Select Health
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$1,000.00
Typical High
$1,513.56
Select Health
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$954.99
Typical High
$1,047.13
United
Setting
Facility
Modifier
Global
Typical Low
$0.63
Median
$457.09
Typical High
$489.78
United
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$398.11
Typical High
$562.34