SEWHFO, Shoulder Cap, with Joints, Custom Fabricated
New Jersey 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 October 2026.
How much does SEWHFO, Shoulder Cap, with Joints, Custom Fabricated cost?
$1,000
Typical negotiated rate. In New Jersey, October 2026.
Insurers have agreed to pay about $1,000 for this service. The price depends on where it is billed: about $1,000 from a physician practice, and about $1,349 from a hospital or other facility.
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.
Prices by location type
Billed by
Who charges it
Typical
Range
Physician practiceA doctor's office, clinic or independent provider
A doctor's office, clinic or independent provider
$1,000
$832 to $2,042
FacilityA hospital or hospital-owned outpatient department
A hospital or hospital-owned outpatient department
$1,349
$1,349 to $1,349
How much rates vary
Facilitymedian $1,349 · 10th to 90th $692 to $2,042Professionalmedian $1,000 · 10th to 90th $692 to $2,042
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
Insurance Carrier
Facility/Professional
Modifier
Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Aetna
Setting
Facility
Modifier
None
Typical Low
$691.83
Median
$691.83
Typical High
$794.33
Facility
None
$691.83
$691.83
$794.33
Aetna
Setting
Professional
Modifier
None
Typical Low
$691.83
Median
$691.83
Typical High
$870.96
Professional
None
$691.83
$691.83
$870.96
Cigna
Setting
Facility
Modifier
None
Typical Low
$1,348.96
Median
$1,348.96
Typical High
$2,041.74
Facility
None
$1,348.96
$1,348.96
$2,041.74
Cigna
Setting
Professional
Modifier
None
Typical Low
$977.24
Median
$977.24
Typical High
$1,348.96
Professional
None
$977.24
$977.24
$1,348.96
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$1,348.96
Median
$2,691.53
Typical High
$2,691.53
Professional
None
$1,348.96
$2,691.53
$2,691.53
Horizon BCBS
Setting
Professional
Modifier
None
Typical Low
$2,041.74
Median
$2,041.74
Typical High
$2,041.74
Professional
None
$2,041.74
$2,041.74
$2,041.74
United
Setting
Facility
Modifier
None
Typical Low
$2,137.96
Median
$2,137.96
Typical High
$2,511.89
Facility
None
$2,137.96
$2,137.96
$2,511.89
United
Setting
Professional
Modifier
None
Typical Low
$794.33
Median
$1,071.52
Typical High
$1,949.84
Professional
None
$794.33
$1,071.52
$1,949.84
Where New Jersey sits
The same service costs 2.2 times more in Montana than in Vermont. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.