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Utah 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 $1,023 · 10th–90th $525–$1,8620%20%40%10th90th$1,023Professionalmedian $1,288 · 10th–90th $525–$7,7620%10%10th90th$1,288$50.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $1,047.13 / $7,762.47
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,023.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,023.29
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $1,348.96 / $1,737.80
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,862.09 / $1,862.09
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,318.26 / $1,995.26
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,862.09 / $1,905.46
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,905.46 / $2,187.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $812.83 / $1,071.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $812.83 / $1,380.38