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Idaho 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 $2,042 · 10th–90th $1,122–$2,5700%20%10th90th$2,042Professionalmedian $1,445 · 10th–90th $871–$2,3990%10%10th90th$1,445$50.0$100.0$200.0$500.0$1.0K$2.0K$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
$870.96 / $1,258.93 / $1,862.09
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,041.74 / $3,467.37
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,398.83 / $2,398.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,548.82 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,548.82
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $2,041.74 / $2,344.23
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,949.84 / $2,187.76
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $1,819.70
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,089.30 / $2,089.30
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,513.56 / $2,290.87
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,187.76 / $2,238.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,122.02 / $1,258.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $977.24 / $1,412.54