Custom shoulder-elbow-wrist-hand brace with shoulder cap

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 cap design w/jnt(s) cf

Payers reporting HCPCS L3971

54 payers file a negotiated rate for this code. Each is shown once, under the terms the most hospitals file it under; rates under different terms (billing class, payment method, setting) are never blended, so open a payer to see them all. Figures are hospital-level averages; the median is across hospitals.

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1	UnitedHealthcare fee schedule · outpatient · +15 other terms	369	$2,134	$2,122	$577.59 – $6,819
2	Aetna fee schedule · outpatient · +14 other terms	360	$2,127	$2,433	$542.51 – $13,744
3	Humana fee schedule · outpatient · +15 other terms	318	$2,108	$3,151	$1,011 – $16,286
4	Blue Cross Blue Shield fee schedule · outpatient · +11 other terms	231	$2,160	$2,710	$0.29 – $10,202
5	WellCare fee schedule · outpatient · +6 other terms	208	$2,181	$2,238	$2,015 – $4,010
6	Devoted fee schedule · outpatient · +4 other terms	165	$2,117	$2,129	$2,046 – $2,558
7	Molina fee schedule · outpatient · +8 other terms	138	$3,014	$2,915	$1,462 – $5,547
8	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$2,160	$2,157	$2,117 – $2,582
9	Cigna fee schedule · outpatient · +14 other terms	105	$2,181	$2,360	$721.98 – $6,171
10	Anthem fee schedule · outpatient · +12 other terms	81	$2,087	$2,880	$1,380 – $15,795
11	Kaiser fee schedule · outpatient · +6 other terms	64	$2,172	$3,383	$2,046 – $15,086
12	Superior Healthplan fee schedule · outpatient	41	$2,223	$2,200	$42.00 – $2,223
13	Caresource fee schedule · outpatient · +5 other terms	40	$2,117	$2,186	$1,380 – $3,255
14	Clover fee schedule · outpatient · +2 other terms	37	$2,117	$2,130	$2,015 – $2,508
15	Oscar fee schedule · outpatient · +5 other terms	36	$2,223	$2,444	$2,075 – $3,563
16	Ambetter facility · fee schedule · outpatient · +5 other terms	34	$3,791	$3,969	$2,015 – $5,293
17	Optum fee schedule · outpatient · +4 other terms	33	$2,117	$2,766	$2,032 – $5,293
18	Medica facility · fee schedule · outpatient · +5 other terms	22	$2,154	$1,976	$702.00 – $3,491
19	Amerihealth Caritas fee schedule · outpatient · +2 other terms	18	$2,541	$2,470	$2,097 – $2,541
20	Bcbs Tx fee schedule · outpatient · +2 other terms	18	$2,076	$2,076	$2,076 – $2,076
21	Medicare fee schedule · outpatient · +2 other terms	18	$2,046	$2,053	$2,046 – $2,087
22	Regence facility · fee schedule · outpatient · +4 other terms	18	$2,214	$2,141	$1,713 – $2,257
23	Medical Mutual facility · fee schedule · outpatient · +3 other terms	15	$2,106	$2,427	$1,146 – $3,327
24	Bcbs Mn fee schedule · outpatient · +6 other terms	13	$1,916	$1,915	$931.96 – $2,243
25	Wellmark fee schedule · both · +1 other terms	13	$1,952	$1,941	$1,532 – $1,952

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