go back

Kentucky 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 $1,288 · 10th–90th $955–$3,4670%20%10th90th$1,288Professionalmedian $1,148 · 10th–90th $955–$1,5140%20%10th90th$1,148$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$1,122.02 / $1,122.02 / $1,174.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,122.02 / $1,513.56
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,238.72 / $2,344.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,148.15 / $1,174.90
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,951.21 / $3,801.89
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,754.23 / $3,467.37
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $3,467.37 / $3,467.37
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,737.80 / $10,471.29
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $954.99 / $1,258.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,047.13 / $1,445.44