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Utah rates for HCPCS L3763

Elbow-wrist-hand orthosis (EWHO), rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Facilitymedian $468 · 10th–90th $234–$7410%20%40%10th90th$468Professionalmedian $479 · 10th–90th $234–$8910%5%10%10th90th$479$50.0$100.0$200.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $436.52 / $3,890.45
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
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $549.54 / $691.83
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $741.31 / $741.31
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $831.76
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $812.83
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $758.58 / $977.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $354.81 / $467.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $363.08 / $676.08