go back

Iowa 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 $851 · 10th–90th $513$2,6300%20%10th90th$851Professionalmedian $490 · 10th–90th $380$8910%20%10th90th$490$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
$512.86 / $512.86 / $616.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $467.74 / $776.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $1,000.00 / $1,258.93
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $912.01 / $1,023.29
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $1,047.13 / $4,265.80
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $562.34 / $1,348.96
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $933.25 / $1,230.27
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $912.01
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,348.96 / $1,348.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $870.96 / $2,137.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $436.52 / $870.96
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $776.25 / $776.25