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Tennessee 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
$673.47 / $673.47 / $735.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$632.39 / $694.64 / $1,260.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.90 / $1,347.26 / $1,347.26
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 / $606.70 / $831.10
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,338.98 / $6,933.23 / $6,933.23
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,495.95 / $7,495.95 / $10,898.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$497.87 / $718.84 / $999.54