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Indiana rates for HCPCS L3765

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

Facilitymedian $1,445 · 10th–90th $692–$1,7780%50%10th90th$1,445Professionalmedian $724 · 10th–90th $603–$1,2300%50%10th90th$724$1.0$5.0$20.0$100.0$500.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $691.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $691.83 / $1,230.27
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $1,445.44 / $1,778.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $741.31 / $1,318.26
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,819.70 / $2,137.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $912.01 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $1,548.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $812.83 / $1,148.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $691.83 / $1,000.00