go back

West Virginia 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
Facility
Modifier
Low / Median / High Price
$1,410.00 / $1,410.00 / $1,410.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$361.80 / $378.48 / $450.61
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$568.95 / $1,014.19 / $1,314.69
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$488.31 / $612.71 / $1,050.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$488.53 / $488.53 / $1,025.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.63 / $629.79 / $755.97
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$532.39 / $532.39 / $1,250.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.56 / $427.94 / $733.55