go back

Maryland 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
Professional
Modifier
Low / Median / High Price
$323.73 / $391.09 / $618.32
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$424.00 / $424.00 / $540.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$494.25 / $494.25 / $494.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.80 / $360.80 / $494.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.69 / $790.98 / $1,139.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.30 / $394.61 / $629.01
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$473.88 / $473.88 / $553.69