go back

New Hampshire 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
$818.24 / $818.24 / $981.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$598.05 / $634.92 / $882.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,453.18 / $1,453.18 / $1,722.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$804.54 / $804.54 / $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 / $3,631.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$483.32 / $724.97 / $860.82
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,088.38 / $1,197.22 / $1,523.73