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Massachusetts 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
$634.92 / $634.92 / $634.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$634.92 / $687.33 / $930.73
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,300.17 / $4,139.57 / $6,933.23
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.50 / $1,079.50 / $1,419.12
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,586.70 / $1,876.50 / $2,416.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,046.72 / $1,120.27 / $1,120.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.10 / $831.10 / $831.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$606.70 / $831.10 / $1,726.13
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,176.58 / $1,176.58 / $1,235.41
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,060.88 / $1,060.88 / $1,060.88
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,022.47 / $6,933.23 / $6,933.23
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$552.96 / $724.97 / $1,419.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.38 / $776.78 / $1,419.12