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SEWHFO, Shoulder Cap, with Joints, Custom Fabricated

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

Rates data updated July 2026.

How much does SEWHFO, Shoulder Cap, with Joints, Custom Fabricated cost?

$1,072

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $1,072 for this service. The price depends on where it is billed: about $1,072 from a physician practice, and about $2,089 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,072$1,047 to $1,738
FacilityA hospital or hospital-owned outpatient department$2,089$1,072 to $3,715

How much rates vary

Facilitymedian $2,089 · 10th to 90th $1,072 to $10,715Professionalmedian $1,072 · 10th to 90th $955 to $2,089
$10.0$100.0$1.0K$10.0Kfacility $2,089professional $1,072

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,071.52
Median
$1,071.52
Typical High
$2,089.30
Aetna
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$1,071.52
Typical High
$2,089.30
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,511.89
Median
$3,981.07
Typical High
$14,125.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,348.96
Median
$1,348.96
Typical High
$2,290.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$977.24
Typical High
$2,238.72
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$1,737.80
Median
$2,290.87
Typical High
$2,818.38
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$2,691.53
Median
$2,691.53
Typical High
$2,691.53
United
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$1,698.24
Typical High
$2,089.30
United
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,023.29
Typical High
$1,778.28

Where Illinois sits

The same service costs 2.5 times more in Wisconsin than in Washington, DC. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Illinois $1,072 · 36th of 51
WI $2,042DC $832

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.