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New Hampshire rates for HCPCS L3962

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

Facilitymedian $1,072 · 10th–90th $589–$1,2880%10%20%10th90th$1,072Professionalmedian $646 · 10th–90th $389–$9770%20%10th90th$646$500.0$1.0K$2.0K

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
$588.84 / $588.84 / $707.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $512.86 / $870.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,148.15 / $1,318.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $776.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $489.78
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $1,698.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $407.38 / $524.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $602.56 / $933.25
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,318.26