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New Mexico 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 $1,202 · 10th–90th $525–$1,9050%10%10th90th$1,202Professionalmedian $933 · 10th–90th $759–$1,6600%20%10th90th$933$100.0$200.0$500.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $912.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $933.25 / $1,380.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,202.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $2,238.72
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,862.09 / $2,754.23
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $1,258.93 / $1,905.46
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $1,862.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $891.25 / $2,238.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $812.83 / $1,230.27