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Indiana 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 $2,089 · 10th–90th $1,023–$2,5700%20%40%10th90th$2,089Professionalmedian $1,072 · 10th–90th $912–$1,6980%50%10th90th$1,072$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
$1,023.29 / $1,023.29 / $1,023.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,023.29 / $1,698.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $2,089.30 / $2,630.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,122.02 / $2,041.74
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,691.53 / $3,090.30
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,348.96 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $2,238.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $1,202.26 / $1,698.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $1,023.29 / $1,479.11