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Nationwide rates for HCPCS L3976

Shoulder-elbow-wrist-hand-finger orthosis (SEWHO), abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $954.99 / $1,862.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $954.99 / $1,621.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $1,023.29 / $3,630.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,000.00 / $2,137.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $7,585.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $758.58 / $2,691.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $1,047.13 / $2,238.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $891.25 / $1,445.44