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Louisiana 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
$417.12 / $442.79 / $596.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.45 / $442.79 / $559.51
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$671.75 / $1,147.58 / $1,613.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$458.11 / $547.96 / $547.96
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
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 / $488.53 / $679.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.84 / $385.03 / $613.91