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Maryland 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 $955 · 10th–90th $562–$1,2590%10%10th90th$955Professionalmedian $912 · 10th–90th $741–$1,6220%10%20%10th90th$912$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
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $891.25 / $1,621.81
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $1,258.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,258.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $1,202.26
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,819.70 / $2,754.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $812.83 / $1,258.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $891.25 / $1,445.44
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $1,548.82