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Maine 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
$634.92 / $882.05 / $882.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,292.46 / $1,674.50 / $3,103.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$804.54 / $848.76 / $848.76
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 / $1,188.96
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,176.58 / $1,176.58 / $1,176.58
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$818.24 / $882.05 / $882.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$483.32 / $724.97 / $1,667.21