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North Dakota 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
$537.03 / $912.01 / $912.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $436.52 / $575.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $831.76 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $954.99 / $1,202.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $707.95 / $3,715.35
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $371.54 / $741.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $1,174.90 / $1,174.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $501.19 / $870.96