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Georgia 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 $2,138 · 10th–90th $977–$7,7620%10%20%10th90th$2,138Professionalmedian $1,175 · 10th–90th $933–$1,9950%20%10th90th$1,175$2.0$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$977.24 / $977.24 / $2,511.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,071.52 / $1,819.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $5,011.87 / $7,762.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,737.80 / $2,511.89
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $1,778.28
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $1,778.28
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 / $2,511.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,137.96 / $3,090.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $912.01 / $1,698.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,000.00 / $2,041.74