go back

New Mexico rates for HCPCS L3763

Elbow Wrist Hand Orthosis 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
$378.44 / $378.44 / $378.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$378.44 / $581.17 / $2,604.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$462.38 / $616.51 / $734.58
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 / $488.53 / $488.53
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$617.41 / $771.77 / $1,157.65
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$232.26 / $232.26 / $700.27
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.63 / $488.53 / $904.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$332.63 / $359.77 / $541.94