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Elbow-Wrist-Hand Orthosis (EWHO), Nontorsion Joints

Maryland 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

Rates data updated July 2026.

Facilitymedian $479 · 10th–90th $309$1,0000%10%10th90th$479Professionalmedian $437 · 10th–90th $398$7590%20%40%10th90th$437$500.0$1.0K$2.0K$5.0K

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
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$416.87
Typical High
$758.58
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$691.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$575.44
Typical High
$602.56
Cigna
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$575.44
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,000.00
Typical High
$1,513.56
United
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$416.87
Typical High
$1,000.00
United
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$512.86
Typical High
$870.96
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$851.14