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Illinois 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 $2,344 · 10th–90th $1,072–$10,7150%20%10th90th$2,344Professionalmedian $1,072 · 10th–90th $871–$2,0890%20%40%10th90th$1,072$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
$1,071.52 / $1,071.52 / $2,089.30
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,071.52 / $1,862.09
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $3,981.07 / $14,125.38
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
$977.24 / $977.24 / $2,398.83
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,290.87 / $2,818.38
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $2,691.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $1,698.24 / $3,019.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,023.29 / $1,698.24