go back

Washington, DC 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$401.32 / $401.32 / $401.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$401.32 / $401.32 / $401.32
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$596.54 / $596.54 / $670.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$423.04 / $423.04 / $423.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$637.36 / $637.36 / $1,946.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$326.13 / $489.19 / $761.45