go back

Massachusetts 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 $1,259 · 10th–90th $447–$1,8200%20%10th90th$1,259Professionalmedian $603 · 10th–90th $407–$1,0000%20%10th90th$603$1.0$10.0$100.0$1.0K$10.0K

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
$426.58 / $446.68 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $457.09 / $794.33
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,000.00 / $4,365.16
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $831.76 / $1,148.15
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,318.26 / $1,737.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $602.56
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $3,630.78 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $1,348.96
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $549.54
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,000.00 / $4,365.16
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $831.76 / $1,148.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $512.86 / $1,096.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $776.25 / $912.01