go back

Kentucky rates for HCPCS L3763

Elbow Wrist Hand Orthosis 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
$449.89 / $612.74 / $878.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.45 / $440.74 / $612.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$544.87 / $875.30 / $919.94
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$411.12 / $411.12 / $495.89
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$656.48 / $1,148.81 / $1,312.93
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.54 / $1,050.35 / $1,444.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$488.53 / $488.53 / $1,025.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.63 / $629.79 / $906.65
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$410.96 / $510.48 / $626.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.20 / $409.38 / $746.00