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

Mississippi 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 $676 · 10th–90th $457$1,0960%20%40%10th90th$676Professionalmedian $501 · 10th–90th $372$8130%10%20%10th90th$501$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
Facility
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$794.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$512.86
Typical High
$812.83
BCBS
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$676.08
Typical High
$676.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$676.08
Typical High
$676.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$575.44
Typical High
$575.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$575.44
United
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$707.95
Typical High
$1,318.26
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$416.87
Typical High
$645.65