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Washington, DC 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
$561.66 / $561.66 / $561.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$561.66 / $561.66 / $561.66
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$876.61 / $876.61 / $938.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.45 / $662.45 / $662.45
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$892.00 / $892.00 / $2,724.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$456.42 / $684.64 / $1,028.67