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Vermont 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 $575 · 10th–90th $398–$5750%50%10th$575Professionalmedian $501 · 10th–90th $363–$6610%10%20%10th90th$501$500.0$1.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $501.19 / $660.69
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $575.44
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $1,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $512.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $758.58 / $1,174.90