go back

Minnesota rates for HCPCS L3702

Elbow orthosis (EO), without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $218.78 / $218.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $169.82 / $316.23
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $316.23 / $467.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $316.23 / $316.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $1,202.26 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $416.87 / $467.74
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $1,174.90 / $2,238.72
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $363.08 / $501.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.33 / $316.23 / $575.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $141.25 / $346.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.24 / $141.25 / $389.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $154.88 / $389.05