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South Dakota rates for HCPCS L3962

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

Facilitymedian $617 · 10th–90th $550–$1,0470%20%10th90th$617Professionalmedian $661 · 10th–90th $355–$1,1480%10%20%10th90th$661$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $549.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $549.54 / $870.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $1,047.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $1,148.15
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $851.14 / $1,479.11
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $562.34 / $5,011.87
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,023.29 / $1,023.29
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,047.13
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $1,412.54
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $794.33 / $1,047.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $562.34 / $933.25
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $870.96