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Indiana 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
$736.92 / $736.92 / $1,488.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$708.58 / $739.63 / $799.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,176.23 / $1,332.57 / $1,488.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$726.32 / $804.54 / $1,086.11
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.71 / $1,637.79 / $2,233.35
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,265.57 / $1,637.79 / $2,010.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.10 / $831.10 / $1,488.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$606.70 / $831.10 / $1,527.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$442.36 / $718.84 / $999.76