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Illinois 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
Facility
Modifier
Low / Median / High Price
$765.26 / $765.26 / $765.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$598.05 / $765.26 / $1,272.46
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,116.68 / $1,116.68 / $1,116.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,779.21 / $3,010.11 / $12,810.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$894.21 / $1,131.56 / $1,131.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.10 / $831.10 / $1,629.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$606.70 / $1,091.08 / $1,507.48
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,265.57 / $1,669.50 / $2,055.00
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,935.57 / $1,935.57 / $1,935.57
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$970.82 / $1,386.89 / $1,456.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$552.96 / $742.79 / $1,275.13