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Hawaii 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
$494.71 / $494.71 / $494.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,154.42 / $1,154.42 / $1,154.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.10 / $831.10 / $1,598.50
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,453.18 / $1,521.65 / $1,521.65
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$871.91 / $1,453.18 / $2,034.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$779.33 / $1,154.42 / $1,598.50
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,170.58 / $1,210.71 / $1,383.16