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New Mexico 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 $2,089 · 10th–90th $398–$6,9180%5%10th90th$2,089Professionalmedian $447 · 10th–90th $398–$7940%20%10th90th$447$100.0$500.0$2.0K$10.0K$50.0K

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
$407.38 / $407.38 / $407.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $446.68 / $630.96
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $4,466.84 / $7,244.36
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $676.08 / $794.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $1,047.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $831.76 / $1,258.93
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $630.96 / $1,047.13
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $933.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $446.68 / $1,096.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $407.38 / $616.60