go back

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

Georgia 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 $891 · 10th–90th $417$3,2360%20%10th90th$891Professionalmedian $550 · 10th–90th $417$1,0000%20%10th90th$550$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
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$1,071.52
Aetna
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$457.09
Typical High
$812.83
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$891.25
Median
$2,137.96
Typical High
$3,235.94
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$724.44
Typical High
$1,096.48
CareSource
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$741.31
Typical High
$741.31
CareSource
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$741.31
Typical High
$741.31
Cigna
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$575.44
Typical High
$575.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$1,071.52
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$891.25
Typical High
$1,348.96
United
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$407.38
Typical High
$891.25
United
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$436.52
Typical High
$977.24