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Ohio 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 $2,239 · 10th–90th $1,175$3,8020%20%40%10th90th$2,239Professionalmedian $1,148 · 10th–90th $933$1,9500%50%10th90th$1,148$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
$1,174.90 / $1,698.24 / $2,041.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,096.48 / $1,513.56
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,344.23 / $4,786.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,288.25 / $2,884.03
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,862.09 / $2,630.27
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,949.84 / $2,951.21
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
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $1,548.82
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,548.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,862.09 / $2,691.53
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $2,691.53
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,511.89 / $4,570.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $1,778.28 / $2,630.27
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,047.13 / $1,479.11