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Kansas 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$674.45 / $674.45 / $724.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.32 / $441.88 / $674.45
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$880.72 / $960.92 / $1,019.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$953.78 / $953.78 / $953.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$579.51 / $579.51 / $579.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$423.04 / $579.51 / $1,244.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$262.32 / $674.45 / $4,272.47
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.89 / $417.11 / $989.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.89 / $406.33 / $602.50