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Alabama rates for HCPCS L3763

Elbow-wrist-hand orthosis (EWHO), rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$789.44 / $789.44 / $789.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$373.70 / $789.44 / $789.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$592.02 / $592.02 / $592.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$488.53 / $488.53 / $820.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.63 / $488.53 / $833.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.84 / $403.75 / $613.96