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New Hampshire 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 $437–$9330%20%40%10th90th$794Professionalmedian $525 · 10th–90th $355–$8320%20%10th90th$525$500.0$1.0K$2.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $524.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $436.52 / $691.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $851.14 / $977.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $457.09
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 / $1,258.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $354.81 / $467.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $630.96 / $741.31
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,122.02