go back

Arizona rates for HCPCS L3967

Shoulder-elbow-wrist-hand orthosis (SEWHO), abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Facilitymedian $1,738 · 10th–90th $631–$4,1690%10%10th90th$1,738Professionalmedian $1,122 · 10th–90th $891–$1,9500%20%10th90th$1,122$2.0$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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,148.15 / $1,949.84
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $2,290.87 / $4,365.16
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,089.30 / $4,073.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $1,548.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,548.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $1,445.44 / $10,232.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $977.24 / $10,964.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $1,737.80 / $1,737.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $977.24 / $1,445.44