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Missouri 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

Facilitymedian $1,479 · 10th–90th $955–$3,7150%20%10th90th$1,479Professionalmedian $1,000 · 10th–90th $759–$1,6600%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
$954.99 / $954.99 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $954.99 / $1,584.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $1,862.09 / $6,606.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,000.00 / $1,737.80
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,862.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,071.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,023.29
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $1,479.11 / $4,073.80
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $912.01 / $9,332.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $1,479.11 / $1,479.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $891.25 / $1,380.38