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South Carolina 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 $1,380 · 10th–90th $1,047–$2,7540%10%20%10th90th$1,380Professionalmedian $1,122 · 10th–90th $933–$1,9050%20%10th90th$1,122$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
$1,071.52 / $1,071.52 / $1,071.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,122.02 / $1,905.46
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,344.23 / $2,818.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $2,511.89
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,584.89 / $3,467.37
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $630.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $1,479.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $1,202.26 / $2,630.27
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,071.52 / $1,445.44