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SEWHO, Abduction Positioning, Erb's Palsy, Prefabricated

Michigan 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 $1,072 · 10th–90th $447$3,1620%20%10th90th$1,072Professionalmedian $501 · 10th–90th $380$8320%20%10th90th$501$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
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$446.68
Aetna
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$446.68
Typical High
$588.84
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$2,398.83
Typical High
$4,570.88
BCBS
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$794.33
Typical High
$831.76
CareSource
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$616.60
Typical High
$616.60
Cigna
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$489.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$489.78
Typical High
$977.24
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$1,513.56
Typical High
$1,698.24
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$645.65
Typical High
$977.24
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$660.69
Typical High
$977.24
United
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$645.65
Typical High
$1,071.52
United
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$380.19
Typical High
$602.56