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California rates for HCPCS L3764

Elbow-wrist-hand orthosis (EWHO), includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Facilitymedian $468 · 10th–90th $372$2,1380%20%10th90th$468Professionalmedian $490 · 10th–90th $398$3,8020%20%40%10th90th$490$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$489.78 / $489.78 / $4,466.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $489.78 / $3,981.07
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $467.74 / $2,137.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $501.19 / $1,513.56
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $1,513.56 / $2,454.71
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,905.46 / $3,890.45
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $575.44
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $933.25 / $1,258.93
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $954.99 / $1,659.59
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,365.16 / $4,365.16 / $4,365.16
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,128.61 / $7,762.47 / $7,762.47
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $831.76
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $912.01 / $1,318.26
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $870.96
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $1,949.84
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $851.14 / $1,318.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $398.11 / $1,096.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $489.78 / $1,071.52