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Elbow-Wrist-Hand Orthosis (EWHO), Nontorsion Joints

South Dakota 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

Rates data updated July 2026.

How much does Elbow-Wrist-Hand Orthosis (EWHO), Nontorsion Joints cost?

$776

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $776 for this service. The price depends on where it is billed: about $776 from a physician practice, and about $813 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$776$575 to $1,000
FacilityA hospital or hospital-owned outpatient department$813$631 to $977

How much rates vary

Facilitymedian $813 · 10th to 90th $575 to $1,514Professionalmedian $776 · 10th to 90th $513 to $1,259
$500.0$1.0K$2.0K$5.0Kfacility $813professional $776

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$616.60
Typical High
$616.60
Aetna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$575.44
Typical High
$776.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$575.44
Typical High
$912.01
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$1,258.93
Medica
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$831.76
Typical High
$1,584.89
Medica
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$602.56
Typical High
$5,011.87
Midlands
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$891.25
Typical High
$891.25
Midlands
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$912.01
Typical High
$912.01
Midlands
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$741.31
Typical High
$1,513.56
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$851.14
Typical High
$1,122.02
United
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$478.63
Typical High
$676.08
United
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$616.60
Typical High
$1,000.00
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$794.33
Typical High
$794.33

Where South Dakota sits

The same service costs 2.8 times more in Hawaii than in Oklahoma. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

South Dakota $776 · 8th of 51
HI $1,122OK $398

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.