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Illinois rates for HCPCS L3962

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

Facilitymedian $891 · 10th–90th $407–$4,0740%20%10th90th$891Professionalmedian $479 · 10th–90th $363–$8130%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
$407.38 / $407.38 / $812.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $426.58 / $812.83
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,548.82 / $5,495.41
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $602.56 / $602.56
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $537.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $912.01
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $933.25 / $1,174.90
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,023.29
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $602.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $645.65 / $1,288.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $398.11 / $676.08