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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

Facilitymedian $490 · 10th–90th $490–$1,0470%50%90th$490Professionalmedian $479 · 10th–90th $389–$7940%20%10th90th$479$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $489.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $457.09 / $776.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $1,047.13 / $1,258.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $524.81 / $1,122.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $1,047.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $426.58
ConnectiCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $912.01
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $724.44 / $1,174.90
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $549.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $398.11 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $512.86 / $954.99