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Elbow-Wrist-Hand-Finger Orthosis (EWHFO), Rigid

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

Rates data updated July 2026.

Facilitymedian $1,445 · 10th–90th $692$1,7780%50%10th90th$1,445Professionalmedian $724 · 10th–90th $562$1,1480%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
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$691.83
Typical High
$691.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$691.83
Typical High
$870.96
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$1,445.44
Typical High
$1,778.28
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$741.31
Typical High
$1,318.26
CareSource
Setting
Facility
Modifier
Global
Typical Low
$1,412.54
Median
$1,819.70
Typical High
$2,137.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$912.01
Typical High
$1,949.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$1,548.82
United
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$870.96
Typical High
$1,445.44
United
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$691.83
Typical High
$1,000.00