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New York 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 $832 · 10th–90th $407$1,9050%10%20%10th90th$832Professionalmedian $501 · 10th–90th $398$1,4450%20%10th90th$501$1.0$10.0$100.0$1.0K$10.0K

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 / $660.69 / $1,174.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $457.09 / $660.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $2,137.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $1,659.59
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $870.96 / $870.96
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $870.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $1,047.13
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,737.80 / $4,073.80
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,047.13 / $1,995.26
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $794.33
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $660.69 / $758.58
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,023.29 / $1,023.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $478.63 / $2,511.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $691.83 / $1,737.80
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $758.58 / $794.33
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $660.69 / $758.58