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Arizona rates for HCPCS L3977

Shoulder-elbow-wrist-hand-finger orthosis (SEWHO), shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Facilitymedian $1,660 · 10th–90th $550–$3,8900%10%10th90th$1,660Professionalmedian $1,072 · 10th–90th $851–$1,8620%20%10th90th$1,072$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
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,071.52 / $1,862.09
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $1,995.26 / $3,715.35
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,819.70 / $3,548.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $1,348.96
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $1,348.96 / $9,549.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $912.01 / $10,471.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $1,659.59 / $1,659.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $912.01 / $1,380.38