go back

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

North Carolina 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 $759 · 10th–90th $398$1,8200%10%20%10th90th$759Professionalmedian $661 · 10th–90th $407$7590%50%10th90th$661$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
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Aetna
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$758.58
Typical High
$758.58
BCBS
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$870.96
Typical High
$1,737.80
BCBS
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$707.95
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
$602.56
Medcost
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$416.87
Typical High
$660.69
Medcost
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$831.76
Typical High
$1,513.56
United
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$707.95
Typical High
$891.25
United
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$436.52
Typical High
$707.95
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$4,365.16
Median
$4,365.16
Typical High
$4,365.16
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$5,128.61
Median
$5,128.61
Typical High
$7,762.47