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Upper Extremity Fracture Orthosis, Humeral, Prefabricated

Utah rates for HCPCS L3980

Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment

Rates data updated July 2026.

Facilitymedian $170 · 10th–90th $110$3390%20%40%10th90th$170Professionalmedian $219 · 10th–90th $110$1,9950%5%10%10th90th$219$50.0$100.0$200.0$500.0$1.0K$2.0K

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
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$109.65
Aetna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$218.78
Typical High
$1,995.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$229.09
Typical High
$229.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$229.09
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$251.19
Typical High
$323.59
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$338.84
Typical High
$338.84
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$245.47
Typical High
$380.19
Select Health
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
Select Health
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$346.74
Typical High
$346.74
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$346.74
Typical High
$416.87
United
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$194.98
Typical High
$316.23
United
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$169.82
Typical High
$263.03