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Nebraska 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 $1,413 · 10th–90th $617–$6,6070%10%20%10th90th$1,413Professionalmedian $891 · 10th–90th $468–$3,8020%10%10th90th$891$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
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $891.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $891.25 / $6,025.60
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,348.96 / $1,380.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $1,584.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,621.81 / $2,398.83
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,548.82 / $6,606.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $691.83 / $1,380.38
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $3,801.89
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,584.89 / $1,584.89
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $3,467.37 / $3,801.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $741.31 / $1,445.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $691.83 / $1,096.48