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SEWHO, Abduction Positioning, Erb's Palsy, Prefabricated

Pennsylvania 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 $324$2,8180%20%10th90th$1,072Professionalmedian $389 · 10th–90th $324$7940%20%40%10th90th$389$1.0$10.0$100.0$1.0K$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
$323.59
Median
$323.59
Typical High
$1,258.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$389.05
Typical High
$660.69
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$794.33
Typical High
$794.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$1,318.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$489.78
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,047.13
Typical High
$1,548.82
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$812.83
Typical High
$812.83
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$562.34
Typical High
$812.83
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$1,258.93
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$389.05
Typical High
$758.58
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$416.87
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$1,905.46
Typical High
$3,090.30
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$758.58
Typical High
$758.58
United
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$1,071.52
Typical High
$1,071.52
United
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$398.11
Typical High
$812.83