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Florida 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 $427 · 10th–90th $372–$7940%20%40%10th90th$427Professionalmedian $457 · 10th–90th $372–$7590%20%40%10th90th$457$1.0$5.0$20.0$100.0$500.0$2.0K

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
$371.54 / $398.11 / $457.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $457.09 / $758.58
AvMed
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $891.25
AvMed
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $831.76 / $891.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $575.44
Florida Blue
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $724.44 / $1,000.00
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $537.03 / $1,000.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $309.03 / $389.05
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $436.52 / $1,096.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $436.52 / $616.60
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $891.25