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Minnesota 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 $2,399 · 10th–90th $1,778–$15,1360%20%10th90th$2,399Professionalmedian $2,042 · 10th–90th $1,047–$2,3990%50%10th90th$2,042$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
$1,445.44 / $1,445.44 / $1,445.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,202.26 / $1,445.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,041.74 / $2,691.53
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,041.74 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,786.30 / $7,762.47 / $18,620.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,754.23 / $3,019.95
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,165.95 / $7,762.47 / $15,135.61
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $3,235.94
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $2,041.74 / $9,549.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $912.01 / $2,238.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.79 / $912.01 / $3,019.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,071.52 / $2,884.03