go back

Other Upper Limb Orthosis

Pennsylvania rates for HCPCS L3999

Upper limb orthosis, not otherwise specified

Rates data updated October 2026.

How much does Other Upper Limb Orthosis cost?

$5.62

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $5.62 for this service. The price depends on where it is billed: about $5.62 from a physician practice, and about $75.86 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 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$5.62$1.17 to $5.62
FacilityA hospital or hospital-owned outpatient department$75.86$58.88 to $129

How much rates vary

Facilitymedian $76 · 10th to 90th $35 to $5,012Professionalmedian $6 · 10th to 90th $1 to $6
$1$10$100$1K$10K$100Kfacility $76professional $6

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$4,265.80
Median
$5,011.87
Typical High
$79,432.82
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$58,884.37
Median
$58,884.37
Typical High
$58,884.37
Cigna
Setting
Facility
Modifier
None
Typical Low
$34.67
Median
$34.67
Typical High
$34.67
Cigna
Setting
Professional
Modifier
None
Typical Low
$1.17
Median
$5.62
Typical High
$5.62
Highmark BCBS
Setting
Facility
Modifier
None
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
Highmark BCBS
Setting
Professional
Modifier
None
Typical Low
$7.94
Median
$7.94
Typical High
$7.94
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$51.29
Median
$70.79
Typical High
$114.82

Where Pennsylvania sits

The same service costs 426.6 times more in Georgia than in Rhode Island. 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.

Pennsylvania· 41st of 51

$5.62

GA $501RI $1.17

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.