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New Hampshire rates for HCPCS L3740

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

Facilitymedian $1,585 · 10th–90th $891–$1,9050%20%40%10th90th$1,585Professionalmedian $1,023 · 10th–90th $631–$1,4790%20%10th90th$1,023$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
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $1,071.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $891.25 / $1,071.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,698.24 / $1,949.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $741.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $741.31
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $616.60 / $912.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $891.25 / $1,380.38
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,513.56 / $2,238.72