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Virginia 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 $1,000 · 10th–90th $447$1,2880%20%40%10th90th$1,000Professionalmedian $490 · 10th–90th $398$8910%20%40%10th90th$490$1.0$5.0$20.0$100.0$500.0$2.0K$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
$398.11 / $478.63 / $1,258.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $478.63 / $758.58
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,071.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $1,047.13
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $691.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $575.44 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $426.58
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,000.00 / $1,412.54
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $660.69 / $660.69
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $645.65 / $1,174.90
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $645.65 / $1,258.93
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $891.25 / $2,884.03
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $891.25 / $2,884.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $426.58 / $1,096.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $489.78 / $870.96