go back

Missouri 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
Facility
Modifier
Low / Median / High Price
$483.32 / $483.32 / $643.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$406.55 / $500.90 / $764.53
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$923.26 / $969.42 / $4,261.77
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$450.53 / $481.00 / $747.30
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 / $526.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$439.65 / $747.29 / $4,154.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$326.94 / $460.60 / $1,122.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$326.94 / $460.38 / $948.74