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SEWHO, Abduction Positioning, Erb's Palsy, Prefabricated

Washington 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 $955 · 10th–90th $661$1,9500%20%10th90th$955Professionalmedian $813 · 10th–90th $398$1,5850%10%20%10th90th$813$10.0$50.0$200.0$1.0K$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$1,584.89
Aetna
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$660.69
Typical High
$4,570.88
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$954.99
Typical High
$977.24
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$851.14
Typical High
$1,096.48
Cigna
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$489.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$489.78
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$1,174.90
Typical High
$2,818.38
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$1,071.52
Typical High
$1,819.70
Molina
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$758.58
Typical High
$831.76
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$776.25
Median
$954.99
Typical High
$977.24
Pacific Source
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$977.24
Typical High
$977.24
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$1,445.44
Typical High
$1,949.84
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$812.83
Typical High
$954.99
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$977.24
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$851.14
Typical High
$1,096.48
United
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$1,071.52
Typical High
$1,288.25
United
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$457.09
Typical High
$776.25
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$478.63
Typical High
$851.14