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New Mexico 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 $1,349 · 10th–90th $589–$2,1380%10%10th90th$1,349Professionalmedian $1,047 · 10th–90th $851–$1,8620%20%10th90th$1,047$100.0$200.0$500.0$1.0K$2.0K$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 / $1,047.13 / $1,548.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $2,511.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,089.30 / $3,090.30
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $1,412.54 / $2,137.96
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $2,089.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $1,000.00 / $2,511.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $912.01 / $1,380.38