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Iowa 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 $2,042 · 10th–90th $1,096$5,8880%20%10th90th$2,042Professionalmedian $1,122 · 10th–90th $851$2,1380%20%10th90th$1,122$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
$1,288.25 / $1,288.25 / $1,513.56
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,096.48 / $1,819.70
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $2,290.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,398.83 / $3,019.95
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,137.96 / $2,344.23
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,454.71 / $9,549.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,258.93 / $3,467.37
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,344.23 / $2,818.38
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,290.87 / $2,290.87
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,467.37 / $3,467.37
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $2,089.30 / $4,897.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,023.29 / $1,949.84
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,949.84 / $1,949.84