go back

California 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 $1,122 · 10th–90th $891$5,1290%20%10th90th$1,122Professionalmedian $1,175 · 10th–90th $933$8,1280%20%40%10th90th$1,175$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
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $9,332.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,174.90 / $8,128.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,122.02 / $4,786.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,174.90 / $3,162.28
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $3,162.28 / $5,011.87
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $3,890.45 / $7,943.28
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
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,412.54 / $2,570.40
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,949.84 / $3,388.44
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,232.93 / $10,232.93 / $10,232.93
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,220.18 / $15,848.93 / $15,848.93
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $2,187.76
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $2,137.96 / $2,754.23
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $2,089.30
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,479.11 / $1,949.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $954.99 / $2,630.27
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,071.52 / $2,290.87