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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

Facilitymedian $724 · 10th–90th $263–$1,0000%20%10th90th$724Professionalmedian $676 · 10th–90th $389–$9550%20%40%10th90th$676$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
$630.96 / $676.08 / $724.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $446.68 / $630.96
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $954.99 / $1,000.00
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $954.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $1,000.00
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $616.60 / $4,265.80
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $407.38 / $5,011.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $660.69 / $831.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $407.38 / $891.25