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New Mexico 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 $1,445 · 10th–90th $631–$2,2390%10%10th90th$1,445Professionalmedian $1,096 · 10th–90th $891–$1,9500%20%10th90th$1,096$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
$1,071.52 / $1,071.52 / $1,071.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,096.48 / $1,659.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $1,548.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $2,691.53
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,187.76 / $3,311.31
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $1,513.56 / $2,238.72
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $2,238.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $1,047.13 / $2,630.27
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $977.24 / $1,445.44