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Wisconsin 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 $2,089 · 10th–90th $1,862$3,8020%50%10th90th$2,089Professionalmedian $1,349 · 10th–90th $933$3,1620%20%10th90th$1,349$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
$1,047.13 / $1,047.13 / $1,047.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,047.13 / $1,513.56
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $3,467.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,949.84 / $2,344.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $4,897.79 / $10,232.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $3,019.95 / $3,981.07
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,698.24 / $2,630.27
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,995.26 / $2,511.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $2,041.74 / $9,549.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,071.52 / $2,290.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $1,348.96
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,311.31 / $3,311.31
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,398.83 / $4,168.69
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,162.28 / $5,754.40
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $4,168.69 / $9,549.93
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,949.84 / $10,471.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $1,071.52 / $2,089.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,023.29 / $1,737.80