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West Virginia 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
Facility
Modifier
Low / Median / High Price
$708.97 / $708.97 / $708.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.91 / $678.53 / $708.97
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$918.86 / $1,852.62 / $2,401.54
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$892.00 / $989.54 / $1,696.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$907.46 / $907.46 / $1,656.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.45 / $1,041.27 / $1,249.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$525.20 / $695.67 / $1,146.18