go back

SEWHFO, Shoulder Cap, without Joints, Custom Fabricated

Delaware 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

Rates data updated July 2026.

Facilitymedian $1,072 · 10th–90th $1$1,2020%50%10th90th$1,072Professionalmedian $813 · 10th–90th $741$6,9180%20%40%10th90th$813$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$741.31
Typical High
$6,918.31
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,202.26
Typical High
$1,202.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$1,202.26
United
Setting
Facility
Modifier
Global
Typical Low
$1.32
Median
$812.83
Typical High
$1,071.52
United
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$933.25
Typical High
$1,348.96