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Iowa 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 $2,138 · 10th–90th $1,148$6,3100%20%10th90th$2,138Professionalmedian $1,175 · 10th–90th $912$2,2910%20%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
$1,348.96 / $1,348.96 / $1,584.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,148.15 / $1,905.46
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,511.89 / $3,162.28
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,238.72 / $2,454.71
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,570.40 / $10,232.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,318.26 / $3,630.78
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,454.71 / $2,951.21
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,454.71 / $2,454.71
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $3,630.78 / $3,630.78
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,884.03 / $4,677.35
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $2,187.76 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,071.52 / $2,041.74
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,041.74 / $2,041.74