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Hawaii 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 $1,549 · 10th–90th $955–$1,6980%20%10th90th$1,549Professionalmedian $1,259 · 10th–90th $933–$2,2910%10%10th90th$1,259$1.0K$2.0K

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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,122.02 / $1,513.56
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,995.26 / $2,691.53
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $2,290.87
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $2,187.76 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $977.24 / $1,202.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,479.11 / $2,344.23