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Indiana 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 $2,239 · 10th–90th $1,072–$2,7540%50%10th90th$2,239Professionalmedian $1,122 · 10th–90th $955–$1,7780%50%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
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,071.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,071.52 / $1,778.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $2,238.72 / $2,754.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,174.90 / $2,137.96
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,818.38 / $3,311.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,548.82 / $2,238.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $2,398.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $1,258.93 / $1,778.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,071.52 / $1,548.82