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North Dakota 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
$1,034.17 / $1,034.17 / $1,034.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$976.94 / $976.94 / $1,034.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,329.07 / $1,571.43 / $1,610.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,630.13 / $1,646.43 / $2,070.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.68 / $1,034.17 / $6,547.41
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$566.29 / $695.67 / $1,132.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$490.64 / $626.62 / $1,232.35