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Arizona rates for HCPCS L3766

Elbow-wrist-hand-finger orthosis (EWHFO), includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $794.33 / $2,238.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $870.96 / $1,819.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,479.11 / $2,754.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $831.76 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $602.56 / $831.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $977.24 / $3,019.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $660.69 / $7,413.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $870.96 / $1,174.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $660.69 / $1,000.00