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Elbow-Wrist-Hand Orthosis (EWHO), Nontorsion Joints

Connecticut 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

Rates data updated July 2026.

Facilitymedian $603 · 10th–90th $339$1,0470%10%10th90th$603Professionalmedian $490 · 10th–90th $363$9770%20%10th90th$490$500.0$1.0K$2.0K$5.0K

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
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$446.68
Typical High
$1,071.52
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$1,047.13
Typical High
$1,258.93
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$524.81
Typical High
$1,122.02
Cigna
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$575.44
Typical High
$1,047.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$426.58
ConnectiCare
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$660.69
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$724.44
Typical High
$1,122.02
Health New England
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$549.54
United
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$398.11
Typical High
$537.03
United
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$512.86
Typical High
$954.99