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Montana rates for HCPCS L3765

Elbow-wrist-hand-finger orthosis (EWHFO), rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Facilitymedian $1,380 · 10th–90th $912–$1,7380%20%10th90th$1,380Professionalmedian $832 · 10th–90th $468–$1,7380%10%10th90th$832$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $794.33 / $1,202.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,380.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $1,479.11 / $1,479.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,479.11 / $1,479.11
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,380.38 / $2,691.53
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,380.38 / $2,691.53
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,318.26 / $1,698.24
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,122.02 / $1,479.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $776.25 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $630.96 / $954.99