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Arizona 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
Professional
Modifier
Low / Median / High Price
$548.91 / $699.67 / $1,237.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$360.28 / $1,301.51 / $2,353.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$900.70 / $1,200.94 / $1,636.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$907.46 / $907.46 / $907.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.45 / $907.46 / $1,153.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$404.54 / $784.96 / $6,547.41
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$565.79 / $626.62 / $943.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$565.79 / $626.62 / $943.92