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Tennessee 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 $692 · 10th–90th $398–$4,3650%20%40%10th90th$692Professionalmedian $427 · 10th–90th $389–$7590%20%40%10th90th$427$1.0$5.0$20.0$100.0$500.0$2.0K

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
$389.05 / $426.58 / $691.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $426.58 / $741.31
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $707.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $575.44
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,365.16 / $4,365.16 / $4,365.16
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,128.61 / $7,762.47 / $7,762.47
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $436.52 / $707.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $426.58 / $676.08