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

Michigan 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 $1,698 · 10th–90th $741$5,6230%20%10th90th$1,698Professionalmedian $794 · 10th–90th $661$1,4130%20%10th90th$794$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$794.33
Median
$794.33
Typical High
$794.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$758.58
Typical High
$794.33
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$4,265.80
Typical High
$8,128.31
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,348.96
Median
$1,412.54
Typical High
$1,479.11
CareSource
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$912.01
Typical High
$912.01
Cigna
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$912.01
Typical High
$912.01
Cigna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$933.25
Typical High
$1,548.82
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$2,691.53
Typical High
$3,019.95
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,148.15
Typical High
$1,737.80
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$933.25
Typical High
$1,412.54
United
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$1,148.15
Typical High
$1,698.24
United
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$660.69
Typical High
$1,000.00