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Minnesota 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 $1,000 · 10th–90th $741–$6,3100%20%10th90th$1,000Professionalmedian $851 · 10th–90th $437–$1,0000%20%40%10th90th$851$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
$602.56 / $602.56 / $602.56
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $501.19 / $630.96
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $851.14 / $1,122.02
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $851.14 / $851.14
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $3,235.94 / $7,762.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,122.02 / $1,258.93
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $3,162.28 / $6,309.57
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,348.96
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $851.14 / $4,265.80
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $407.38 / $954.99
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.46 / $398.11 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $478.63 / $1,202.26