Prefabricated abduction orthosis for shoulder and elbow

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Sewho erbs palsey design abd

Payers reporting HCPCS L3962

Payer pricing summary

Low

$279

Average

$1.1k

Median

$938

High

$2.3k

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +18 other terms	358	$831	$1.0k	$556	53%	—	$480 – $6.7k
2	UnitedHealthcare fee schedule · outpatient · +17 other terms	355	$823	$884	$267	30%	—	$395 – $3.3k
3	Humana fee schedule · outpatient · +15 other terms	315	$949	$1.3k	$1.3k	101%	—	$414 – $6.2k
4	Blue Cross Blue Shield fee schedule · outpatient · +12 other terms	215	$984	$1.2k	$643	53%	—	$0 – $3.9k
5	WellCare fee schedule · outpatient · +6 other terms	204	$855	$904	$150	17%	—	$778 – $1.6k
6	Devoted fee schedule · outpatient · +5 other terms	161	$807	$847	$72	8%	—	$775 – $1.1k
7	Molina fee schedule · outpatient · +6 other terms	138	$1.2k	$1.2k	$432	37%	—	$478 – $2.1k
8	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$839	$863	$94	11%	—	$807 – $1.1k
9	Cigna fee schedule · outpatient · +17 other terms	99	$994	$1.0k	$281	27%	—	$775 – $2.4k
10	Anthem fee schedule · outpatient · +9 other terms	81	$807	$1.2k	$1.1k	91%	—	$451 – $6.1k
11	Kaiser fee schedule · outpatient · +6 other terms	64	$823	$1.6k	$1.2k	78%	—	$775 – $7.4k
12	Superior Healthplan fee schedule · outpatient	40	$847	$847	$4	0%	—	$791 – $847
13	Clover fee schedule · outpatient · +2 other terms	37	$847	$879	$97	11%	—	$791 – $1.1k
14	Oscar fee schedule · outpatient · +7 other terms	36	$1.0k	$1.1k	$336	32%	—	$791 – $1.8k
15	Ambetter facility · fee schedule · outpatient · +7 other terms	35	$1.5k	$1.8k	$431	24%	—	$946 – $2.4k
16	Optum fee schedule · outpatient · +5 other terms	31	$807	$1.1k	$424	39%	—	$775 – $2.0k
17	Caresource fee schedule · outpatient · +5 other terms	29	$965	$928	$243	26%	—	$451 – $1.2k
18	Medica facility · fee schedule · outpatient · +5 other terms	22	$459	$593	$305	52%	—	$90 – $1.6k
19	Regence facility · fee schedule · outpatient · +5 other terms	19	$839	$863	$43	5%	—	$807 – $961
20	Amerihealth Caritas fee schedule · outpatient · +2 other terms	18	$1.2k	$1.1k	$104	9%	—	$823 – $1.2k
21	Bcbs Tx fee schedule · outpatient	18	$791	$791	—	—	—	$791 – $791
22	Medicare fee schedule · outpatient · +5 other terms	18	$775	$778	$6	1%	—	$775 – $791
23	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$807	$935	$232	25%	—	$439 – $1.3k
24	Bcbs Mn fee schedule · outpatient · +6 other terms	13	$734	$733	$171	23%	—	$357 – $859
25	Wellmark fee schedule · both · +4 other terms	13	$877	$869	$46	5%	—	$587 – $877

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