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Kentucky 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 $1,202 · 10th–90th $891–$3,3110%20%10th90th$1,202Professionalmedian $1,072 · 10th–90th $912–$1,4450%20%40%10th90th$1,072$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,071.52 / $1,445.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,137.96 / $2,238.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,071.52 / $1,122.02
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,818.38 / $3,630.78
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,570.40 / $3,311.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $3,311.31 / $3,311.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,659.59 / $10,000.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $912.01 / $1,202.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,000.00 / $1,380.38