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Idaho 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 $479–$1,2880%20%10th90th$851Professionalmedian $603 · 10th–90th $389–$1,0000%10%10th90th$603$50.0$100.0$200.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $537.03 / $776.25
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $870.96 / $1,445.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,000.00 / $1,000.00
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
$426.58 / $426.58 / $575.44
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $812.83 / $1,071.52
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $851.14 / $912.01
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $776.25
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $870.96 / $870.96
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $954.99
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $912.01 / $912.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $467.74 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $407.38 / $616.60