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Oklahoma 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
$374.01 / $374.01 / $551.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.16 / $374.01 / $475.06
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 / $494.25 / $494.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$254.75 / $490.36 / $4,154.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.08 / $394.61 / $782.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.08 / $386.38 / $566.12