HCPCS L3764

Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Current code28 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

Prices for HCPCS L3764 by hospital
HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$781 – $6,05919 plans$462$1,155
Deaconess Medical CenterSpokaneFile dated 2026-08-27$1,085 – $3,7719 plans——
Harborview Medical CenterSeattleFile dated 2026-04-01$1,450 – $1,8122 plans$1,110$1,586
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01$1,367 – $2,5465 plans——
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$781 – $6,6517 plans——
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$759 – $3,91517 plans——
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$759 – $3,91517 plans——
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$881 – $3,91512 plans——
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$868 – $3,76310 plans——
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$831 – $2,49310 plans——
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$1,404 – $3,0069 plans$760$1,085
Providence Centralia HospitalCentraliaFile dated 2026-04-01$1,531 – $3,3885 plans——
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$775$1,107
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$1,087 – $2,1027 plans——
Providence St Joseph HospitalChewelahFile dated 2026-04-01—$482$689
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01—$594$848
Providence St Peter HospitalOlympiaFile dated 2026-04-01$770 – $2,9598 plans——
Skagit Valley HospitalMount Vernon$846 – $2,6929 plans$1,047$1,309
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$1,359 – $3,3247 plans——
Swedish IssaquahIssaquahFile dated 2026-04-01$1,359 – $2,0127 plans——
Swedish Medical CenterSeattleFile dated 2026-04-01$1,359 – $3,2379 plans——
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$1,359 – $3,2379 plans——
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$759 – $3,91517 plans——
University of Washington Medical CtrSeattleFile dated 2026-04-01$1,450 – $2,8425 plans$1,278$1,825
Virginia Mason Medical CenterSeattle$868 – $3,1527 plans——
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27$2,2871 plan——
WhidbeyHealth Medical CenterCoupeville—$383 – $1,095$383 – $1,095
Yakima Valley MemorialYakimaFile dated 2026-08-27$781 – $2,35113 plans——

Lowest and highest amounts each hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Equipment fee, Washington
$906 (fee)