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Kentucky 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
$724.44 / $724.44 / $758.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $724.44 / $1,230.27
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $1,445.44 / $1,513.56
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $741.31 / $758.58
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $1,905.46 / $2,454.71
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,778.28 / $2,238.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $2,238.72 / $2,238.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,445.44 / $6,760.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $1,288.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $676.08 / $812.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $660.69 / $933.25