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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
$123.03 / $977.24 / $1,023.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $758.58 / $1,023.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,548.82 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $1,621.81 / $2,041.74
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $1,202.26 / $6,606.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $691.83 / $1,412.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $2,041.74 / $2,041.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $707.95 / $1,513.56