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Montana rates for HCPCS L3971

Shoulder-elbow-wrist-hand orthotic (SEWHO), shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Facilitymedian $2,042 · 10th–90th $1,349–$2,5700%20%40%10th90th$2,042Professionalmedian $1,202 · 10th–90th $692–$2,5700%10%10th90th$1,202$100.0$200.0$500.0$1.0K$2.0K$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
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,174.90 / $1,778.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,187.76 / $2,187.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,187.76 / $2,187.76
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,041.74 / $3,981.07
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,041.74 / $3,981.07
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,949.84 / $2,511.89
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,659.59 / $2,187.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $1,148.15 / $1,202.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $912.01 / $1,412.54