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Oklahoma 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 $912 · 10th–90th $832–$2,6920%20%10th90th$912Professionalmedian $891 · 10th–90th $708–$1,1750%20%10th90th$891$500.0$1.0K$2.0K$5.0K$10.0K

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
$870.96 / $870.96 / $870.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $912.01 / $1,096.48
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 / $1,995.26
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $1,174.90 / $8,511.38
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $891.25 / $2,238.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $1,174.90 / $1,905.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $812.83 / $1,174.90