go back

Arkansas rates for HCPCS L3765

Elbow-wrist-hand-finger orthosis (EWHFO), rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$785.65 / $785.65 / $785.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$585.70 / $785.65 / $785.65
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,220.25 / $1,615.03 / $1,794.48
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,372.31 / $1,372.31 / $1,413.63
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,372.31 / $1,372.31 / $1,372.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$907.46 / $907.46 / $1,130.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.45 / $907.46 / $1,104.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.75 / $636.72 / $944.47