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Montana rates for HCPCS L3763

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

Facilitymedian $724 · 10th–90th $501–$2,1880%20%40%10th90th$724Professionalmedian $479 · 10th–90th $309–$8320%20%10th90th$479$100.0$500.0$2.0K$10.0K$50.0K

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $478.63 / $831.76
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $69,183.10 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $776.25 / $776.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $776.25 / $776.25
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $724.44 / $1,412.54
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $724.44 / $1,412.54
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $758.58 / $912.01
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $588.84 / $776.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $446.68 / $467.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $363.08 / $575.44