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

North Dakota 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 $617 · 10th–90th $603$1,2880%50%10th90th$617Professionalmedian $794 · 10th–90th $490$1,0470%20%10th90th$794$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
$602.56
Median
$616.60
Typical High
$616.60
Aetna
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$602.56
Typical High
$3,981.07
BCBS
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$933.25
Typical High
$977.24
Cigna
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$575.44
Typical High
$575.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$1,000.00
Typical High
$1,258.93
Medica
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$776.25
Typical High
$4,265.80
Medica
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$426.58
Typical High
$851.14
United
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$1,318.26
United
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$616.60
Typical High
$1,000.00