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Nevada 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.45 / $354.45 / $408.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.45 / $401.32 / $415.17
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,037.93 / $1,037.93 / $1,037.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$476.95 / $496.06 / $1,085.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$579.51 / $579.51 / $764.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$423.04 / $543.58 / $596.90
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$577.16 / $830.34 / $1,349.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.14 / $406.33 / $677.22