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Missouri 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 $1,660 · 10th–90th $1,072–$4,1690%20%10th90th$1,660Professionalmedian $1,096 · 10th–90th $871–$1,8620%20%40%10th90th$1,096$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
$1,071.52 / $1,071.52 / $1,230.27
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,071.52 / $1,778.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $7,413.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,122.02 / $1,949.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $2,089.30
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,412.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $1,348.96
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,659.59 / $9,549.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,023.29 / $10,471.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $1,659.59 / $1,659.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,000.00 / $1,548.82