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Montana rates for HCPCS L3740

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

Facilitymedian $1,148 · 10th–90th $776–$1,5850%20%40%10th90th$1,148Professionalmedian $794 · 10th–90th $537–$1,3490%10%10th90th$794$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $707.95 / $1,023.29
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $1,230.27 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,230.27 / $1,230.27
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $1,148.15 / $2,238.72
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,148.15 / $2,238.72
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $1,174.90 / $1,698.24
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $933.25 / $1,230.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $741.31 / $776.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $588.84 / $891.25