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Rhode Island 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
Professional
Modifier
Low / Median / High Price
$340.24 / $433.12 / $461.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,101.00 / $1,487.06 / $1,760.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$372.70 / $438.47 / $704.23
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 / $644.12 / $697.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.19 / $444.73 / $647.50