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Hawaii 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 $575 · 10th–90th $398–$8710%20%10th90th$575Professionalmedian $537 · 10th–90th $437–$1,1750%20%10th90th$537$500.0$1.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $446.68 / $602.56
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $870.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $1,023.29 / $1,380.38
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,174.90
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,122.02 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $407.38 / $512.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $870.96 / $1,202.26