go back

Montana rates for HCPCS L3962

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

Facilitymedian $776 · 10th–90th $513–$9550%20%10th90th$776Professionalmedian $589 · 10th–90th $363–$9550%10%10th90th$589$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$363.08 / $446.68 / $870.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $776.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $831.76 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $831.76 / $831.76
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $776.25 / $1,513.56
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $776.25 / $1,513.56
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $776.25 / $1,071.52
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $616.60 / $933.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $446.68 / $489.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $398.11 / $602.56