go back

Florida 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
$373.70 / $460.46 / $1,045.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$344.65 / $417.00 / $766.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$488.53 / $488.53 / $488.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.63 / $356.63 / $661.20
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$303.26 / $537.51 / $788.14
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$525.17 / $775.53 / $944.55
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.21 / $234.18 / $257.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$332.63 / $427.57 / $568.97
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.18 / $234.18 / $432.06