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Wisconsin rates for HCPCS L3763

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

Facilitymedian $832 · 10th–90th $479–$1,5140%50%10th90th$832Professionalmedian $575 · 10th–90th $363–$1,2590%20%10th90th$575$1.0$5.0$20.0$100.0$500.0$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
$309.03 / $478.63 / $812.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $436.52 / $812.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $1,380.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $1,905.46 / $4,073.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $1,202.26 / $1,584.89
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $707.95 / $1,023.29
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,023.29 / $1,348.96
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $812.83 / $3,715.35
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $426.58 / $1,000.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $158.49
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,318.26
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $933.25 / $1,659.59
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,258.93 / $2,290.87
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $1,659.59 / $4,265.80
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $707.95 / $4,365.16
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $416.87 / $831.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $407.38 / $831.76