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New Jersey 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
$494.71 / $494.71 / $494.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$494.71 / $632.39 / $799.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.10 / $831.10 / $1,453.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$606.70 / $831.10 / $1,272.46
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,327.58 / $1,336.93 / $1,903.67
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,383.16 / $1,453.18 / $1,453.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.50 / $724.97 / $1,453.18