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Utah rates for HCPCS L3740

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

Facilitymedian $741 · 10th–90th $380–$1,1750%20%40%10th90th$741Professionalmedian $813 · 10th–90th $380–$6,7610%10%10th90th$813$50.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $380.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $707.95 / $6,760.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $741.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $741.31
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $851.14 / $1,122.02
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,174.90 / $1,174.90
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $1,318.26
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $1,202.26
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,202.26 / $1,445.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $588.84 / $912.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $588.84 / $954.99