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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
$541.76 / $541.76 / $541.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$450.61 / $541.76 / $570.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$696.24 / $823.20 / $843.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$951.38 / $960.89 / $1,208.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.23 / $692.85 / $3,743.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$296.64 / $419.73 / $613.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.84 / $399.41 / $599.61