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Hawaii 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 $1,349 · 10th–90th $912–$1,5850%20%10th90th$1,349Professionalmedian $1,202 · 10th–90th $871–$2,1380%20%10th90th$1,202$1.0K$2.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,071.52 / $1,445.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,584.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,905.46 / $2,511.89
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,041.74 / $2,137.96
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $2,041.74 / $2,344.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $1,148.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,412.54 / $2,238.72