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Maine rates for HCPCS L3763

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

Facilitymedian $794 · 10th–90th $363–$9770%20%10th90th$794Professionalmedian $457 · 10th–90th $347–$9330%10%20%10th90th$457$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $436.52 / $1,096.48
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $933.25 / $1,047.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $575.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $489.78
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $812.83
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $457.09 / $812.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $354.81 / $354.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $676.08 / $707.95