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

Wisconsin 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 $1,445 · 10th–90th $912$2,6300%20%40%10th90th$1,445Professionalmedian $1,349 · 10th–90th $708$2,3990%20%10th90th$1,349$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
$467.74
Median
$707.95
Typical High
$1,288.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$1,288.25
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,445.44
Median
$1,445.44
Typical High
$2,344.23
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,348.96
Median
$1,348.96
Typical High
$1,621.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$3,311.31
Typical High
$7,244.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$2,089.30
Typical High
$2,691.53
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$1,148.15
Typical High
$1,778.28
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$1,288.25
Median
$1,698.24
Typical High
$2,089.30
Medica
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$1,412.54
Typical High
$6,606.93
Medica
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$741.31
Typical High
$1,548.82
Molina
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$70.79
Typical High
$181.97
Network Health
Setting
Facility
Modifier
Global
Typical Low
$2,290.87
Median
$2,290.87
Typical High
$2,290.87
Network Health
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,621.81
Typical High
$2,818.38
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$1,148.15
Typical High
$1,778.28
Prevea360
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,380.38
Typical High
$1,412.54
Quartz
Setting
Professional
Modifier
Global
Typical Low
$1,445.44
Median
$2,137.96
Typical High
$3,801.89
Quartz
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$2,884.03
Typical High
$6,606.93
Quartz
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$2,137.96
Typical High
$7,244.36
United
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$724.44
Typical High
$1,445.44
United
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$707.95
Typical High
$1,380.38