Custom rigid elbow, wrist and hand brace at Fairview Health Services

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HC ELBOW WRIST HAND ORTHOSIS, W/O JOINTS, CUSTOM FABRICATED

Edina, MN

See all hospitals reporting HCPCS L3763 →

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How this price compares nationally

Fairview Health Services’s median price of $1.1k is 34% above the median hospital's median price ($831), higher than 82% of the 1,315 hospitals reporting HCPCS L3763. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L3763 at Fairview Health Services

Negotiated rates from the hospital’s own file: 8 payers, 43 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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#
1	Bcbs Mn pmap fee schedule · outpatient	$370	$370	—	—	—	$370 – $370
2	Bcbs Mn aware federal fee schedule · both	$761	$761	—	—	—	$761 – $761
3	Bcbs Mn aware/blue plus fee schedule · both	$775	$775	—	—	—	$775 – $775
4	Medica managed medicaid/accessability fee schedule · both	$801	$801	—	—	—	$801 – $801
5	Sanford Health Plan medicare advantage fee schedule · outpatient	$807	$807	—	—	—	$807 – $807
6	UnitedHealthcare medicare advantage fee schedule · outpatient	$807	$807	—	—	—	$807 – $807
7	WellCare medicare advantage fee schedule · outpatient	$807	$807	—	—	—	$807 – $807
8	UnitedHealthcare commercial percent of total billed charges · inpatientfrom % of charges	$818	$818	—	—	—	$818 – $818
9	UnitedHealthcare commercial percent of total billed charges · outpatientfrom % of charges	$818	$818	—	—	—	$818 – $818
10	UnitedHealthcare core percent of total billed charges · inpatientfrom % of charges	$818	$818	—	—	—	$818 – $818
11	UnitedHealthcare core percent of total billed charges · outpatientfrom % of charges	$818	$818	—	—	—	$818 – $818
12	Ucare medicare advantage/msho fee schedule · outpatient	$820	$820	—	—	—	$820 – $820
13	Bcbs Mn medicare advantage fee schedule · outpatient	$840	$840	—	—	—	$840 – $840
14	Medica medicare advantage non-snp fee schedule · outpatient	$856	$856	—	—	—	$856 – $856
15	Ucare pmap fee schedule · outpatient	$863	$863	—	—	—	$863 – $863
16	Medica medicare advantage non-snp fee schedule · both	$870	$870	—	—	—	$870 – $870
17	Bcbs Mn pmap fee schedule · both	$873	$873	—	—	—	$873 – $873
18	Bcbs Mn aware federal fee schedule · outpatient	$876	$876	—	—	—	$876 – $876
19	Medica msho/medicare advantage snp fee schedule · both	$886	$886	—	—	—	$886 – $886
20	Bcbs Mn aware/blue plus fee schedule · outpatient	$892	$892	—	—	—	$892 – $892
21	Ucare pmap fee schedule · both	$894	$894	—	—	—	$894 – $894
22	Medica managed medicaid/accessability fee schedule · outpatient	$986	$986	—	—	—	$986 – $986
23	Medica msho/medicare advantage snp fee schedule · outpatient	$1.1k	$1.1k	—	—	—	$1.1k – $1.1k
24	Sanford Health Plan commercial percent of total billed charges · inpatientfrom % of charges	$1.2k	$1.2k	—	—	—	$1.2k – $1.2k
25	Sanford Health Plan commercial percent of total billed charges · outpatientfrom % of charges	$1.2k	$1.2k	—	—	—	$1.2k – $1.2k

Page 1 of 2 · 43 rates

Last updated: Feb 6, 2026

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