go back

New York 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 $1,698 · 10th–90th $933$3,8900%10%20%10th90th$1,698Professionalmedian $1,175 · 10th–90th $912$3,1620%20%40%10th90th$1,175$2.0$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$724.44 / $1,698.24 / $2,398.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,071.52 / $1,513.56
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $4,365.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $3,548.13
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,778.28 / $1,778.28
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $1,778.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $2,570.40
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,548.13 / $8,317.64
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,187.76 / $4,073.80
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $1,621.81
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,348.96 / $1,548.82
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,089.30 / $2,089.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $1,122.02 / $5,888.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,412.54 / $3,467.37
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,288.25 / $1,621.81
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,348.96 / $1,548.82