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Virginia rates for HCPCS L3962

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

Facilitymedian $813 · 10th–90th $389$1,0230%20%40%10th90th$813Professionalmedian $479 · 10th–90th $347$8320%20%10th90th$479$1.0$5.0$20.0$100.0$500.0$2.0K$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $389.05 / $1,000.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $416.87 / $831.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $851.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $1,000.00
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $549.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $489.78 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $489.78
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $812.83 / $1,122.02
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $524.81 / $794.33
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $549.54 / $1,096.48
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $467.74 / $1,000.00
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $660.69 / $1,737.80
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $660.69 / $1,737.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $416.87 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $398.11 / $645.65