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SEWHO, Abduction Positioning, Erb's Palsy, Prefabricated

South Dakota 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 $794 · 10th–90th $537$1,0720%10%10th90th$794Professionalmedian $759 · 10th–90th $537$1,1480%10%20%10th90th$759$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
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$575.44
Typical High
$575.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$549.54
Typical High
$870.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$1,047.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$912.01
Typical High
$1,148.15
Medica
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$851.14
Typical High
$1,479.11
Medica
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$562.34
Typical High
$5,011.87
Midlands
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,023.29
Typical High
$1,023.29
Midlands
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,047.13
Midlands
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$851.14
Typical High
$1,412.54
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$794.33
Typical High
$1,047.13
United
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$457.09
Typical High
$660.69
United
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$602.56
Typical High
$933.25
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$891.25
Typical High
$891.25