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Kansas 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
$1,096.48 / $1,096.48 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $758.58 / $1,148.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,096.48 / $1,148.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,202.26 / $1,202.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $912.01 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $660.69 / $1,621.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $1,047.13 / $3,388.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $691.83 / $7,079.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.63 / $1,122.02 / $1,122.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $676.08 / $933.25