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New Jersey 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
$467.18 / $467.18 / $491.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.18 / $597.20 / $755.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$907.46 / $907.46 / $1,372.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.45 / $907.46 / $1,201.65
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,253.71 / $1,262.53 / $1,797.73
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,340.15 / $1,372.31 / $1,372.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.16 / $684.64 / $1,372.31