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New Jersey 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 $977 · 10th–90th $355–$9770%50%10th$977Professionalmedian $468 · 10th–90th $372–$1,0470%10%20%10th90th$468$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
$354.81 / $977.24 / $977.24
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $446.68 / $616.60
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $1,047.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $575.44
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $977.24 / $1,445.44
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,047.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $446.68 / $1,047.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $616.60 / $1,047.13