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Elbow-Wrist-Hand-Finger Orthosis (EWHFO), Rigid

Pennsylvania rates for HCPCS L3765

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

Rates data updated July 2026.

Facilitymedian $1,698 · 10th–90th $562$6,6070%20%10th90th$1,698Professionalmedian $676 · 10th–90th $562$1,3800%20%40%10th90th$676$1.0$10.0$100.0$1.0K$10.0K

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
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$2,187.76
Aetna
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$660.69
Typical High
$1,148.15
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$1,380.38
Median
$1,380.38
Typical High
$1,380.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$912.01
Typical High
$1,949.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$912.01
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$1,288.25
Median
$1,819.70
Typical High
$2,630.27
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$1,412.54
Median
$1,412.54
Typical High
$1,412.54
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$977.24
Typical High
$1,412.54
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$2,187.76
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$660.69
Typical High
$1,659.59
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$2,137.96
Median
$4,897.79
Typical High
$7,943.28
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,318.26
Typical High
$1,348.96
United
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$1,698.24
Typical High
$1,698.24
United
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$691.83
Typical High
$1,412.54