go back

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
$1,158.59 / $1,158.59 / $1,158.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$404.54 / $759.08 / $1,158.59
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,003.79 / $1,095.18 / $1,161.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,087.05 / $1,087.05 / $1,087.05
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 / $2,037.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$404.54 / $1,127.58 / $6,547.41
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.75 / $698.01 / $1,339.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.75 / $695.67 / $934.86