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

Tennessee 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 $1,122 · 10th–90th $617$6,6070%20%10th90th$1,122Professionalmedian $676 · 10th–90th $631$1,2020%50%10th90th$676$1.0$5.0$20.0$100.0$500.0$2.0K$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
$630.96
Median
$691.83
Typical High
$1,122.02
Aetna
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$676.08
Typical High
$1,202.26
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,071.52
Typical High
$1,122.02
Cigna
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$912.01
Typical High
$1,047.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$912.01
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$6,606.93
Median
$6,606.93
Typical High
$6,606.93
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$7,244.36
Median
$10,232.93
Typical High
$10,232.93
United
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$724.44
Typical High
$1,445.44
United
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$676.08
Typical High
$933.25