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

Washington 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 $1,380 · 10th–90th $933$2,9510%20%10th90th$1,380Professionalmedian $1,148 · 10th–90th $661$2,4550%10%20%10th90th$1,148$10.0$50.0$200.0$1.0K$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
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$933.25
Typical High
$2,187.76
Aetna
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$933.25
Typical High
$6,025.60
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$1,318.26
Median
$1,348.96
Typical High
$1,380.38
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$1,202.26
Typical High
$1,548.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$912.01
Typical High
$912.01
Cigna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$912.01
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$1,862.09
Typical High
$3,890.45
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,621.81
Typical High
$2,884.03
Molina
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$954.99
Typical High
$1,148.15
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$1,348.96
Typical High
$1,380.38
Pacific Source
Setting
Professional
Modifier
Global
Typical Low
$1,380.38
Median
$1,380.38
Typical High
$1,621.81
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,995.26
Typical High
$2,754.23
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$1,148.15
Typical High
$1,348.96
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$1,348.96
Median
$1,348.96
Typical High
$1,380.38
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$1,202.26
Typical High
$1,548.82
United
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$2,041.74
Typical High
$2,041.74
United
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$724.44
Typical High
$1,202.26
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$977.24
Typical High
$2,089.30