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Missouri 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 $1,778 · 10th–90th $1,122–$4,3650%20%10th90th$1,778Professionalmedian $1,175 · 10th–90th $933–$1,9500%20%40%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
$1,122.02 / $1,122.02 / $1,288.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,148.15 / $1,862.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $7,762.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,174.90 / $2,041.74
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $2,187.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $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
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,737.80 / $10,232.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,071.52 / $10,964.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,778.28 / $1,778.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,047.13 / $1,659.59