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Nebraska 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 $2,188 · 10th–90th $955$10,2330%20%10th90th$2,188Professionalmedian $1,380 · 10th–90th $724$5,8880%10%10th90th$1,380$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
$1,380.38 / $1,380.38 / $1,380.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $1,380.38 / $9,332.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,089.30 / $2,137.96
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 / $3,715.35
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,398.83 / $10,232.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,071.52 / $2,137.96
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $5,888.44
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
$3,019.95 / $5,370.32 / $5,888.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $1,148.15 / $2,238.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,071.52 / $1,698.24