go back

Vermont 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
Professional
Modifier
Low / Median / High Price
$588.84 / $758.58 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $912.01 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $660.69 / $912.01
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,348.96 / $1,659.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $616.60 / $776.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $954.99 / $2,884.03