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North Carolina 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
$766.45 / $1,291.32 / $1,322.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$373.70 / $766.45 / $949.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$701.77 / $842.12 / $1,599.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$609.38 / $656.48 / $700.24
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 / $551.00 / $755.97
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$232.26 / $766.45 / $1,085.65
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$749.82 / $1,034.43 / $1,034.43
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$989.60 / $989.60 / $1,521.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$299.81 / $432.79 / $675.00
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,367.66 / $4,287.21 / $4,287.21
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,332.34 / $6,185.25 / $6,185.25