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Iowa 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 $1,820 · 10th–90th $977–$5,3700%10%10th90th$1,820Professionalmedian $1,000 · 10th–90th $759–$1,8620%20%10th90th$1,000$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $1,348.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $977.24 / $1,621.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $2,041.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $2,137.96 / $2,691.53
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,862.09 / $1,995.26
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,187.76 / $8,511.38
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,122.02 / $3,090.30
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,089.30 / $2,511.89
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,041.74 / $2,041.74
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $3,090.30 / $3,090.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $1,862.09 / $4,365.16
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $912.01 / $1,737.80
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,737.80 / $1,737.80