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Nebraska 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 $891 · 10th–90th $398–$4,2660%20%10th90th$891Professionalmedian $525 · 10th–90th $295–$2,0420%10%20%10th90th$525$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $524.81 / $4,466.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $794.33 / $794.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $1,000.00 / $1,548.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $933.25 / $4,265.80
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $407.38 / $812.83
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $2,187.76
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $912.01
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $2,041.74 / $2,187.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $478.63 / $933.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $407.38 / $676.08