go back

Idaho rates for HCPCS L3962

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

Facilitymedian $871 · 10th–90th $427–$1,2300%20%10th90th$871Professionalmedian $589 · 10th–90th $363–$1,0960%10%10th90th$589$50.0$100.0$200.0$500.0$1.0K$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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $549.54 / $870.96
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $933.25 / $1,584.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,096.48 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $660.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $489.78
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $812.83 / $1,096.48
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $954.99 / $1,000.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $851.14
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $954.99 / $954.99
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $1,047.13
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,000.00 / $1,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $457.09 / $524.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $398.11 / $602.56