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Minnesota rates for HCPCS L3740

Elbow orthosis (EO), double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $812.83 / $812.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $707.95 / $1,023.29
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.15 / $1,174.90 / $1,737.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,174.90 / $1,174.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $4,365.16 / $10,471.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,548.82 / $1,737.80
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,388.44 / $4,365.16 / $8,317.64
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,380.38 / $1,862.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $1,174.90 / $3,162.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $588.84 / $1,380.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.33 / $588.84 / $1,584.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $588.84 / $1,445.44