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Connecticut rates for HCPCS L3975

Shoulder-elbow-wrist-hand-finger orthosis (SEWHO), shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Facilitymedian $871 · 10th–90th $871–$1,8200%50%90th$871Professionalmedian $955 · 10th–90th $759–$1,6600%20%10th90th$955$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $870.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $912.01 / $1,659.59
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,819.70 / $2,187.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,047.13 / $2,398.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $870.96
ConnectiCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $1,621.81
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,288.25 / $1,995.26
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,380.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $812.83 / $1,071.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $891.25 / $1,584.89