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Wisconsin rates for HCPCS L3740

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

Facilitymedian $1,202 · 10th–90th $977–$2,1880%20%40%10th90th$1,202Professionalmedian $813 · 10th–90th $575–$1,8200%20%10th90th$813$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$588.84 / $588.84 / $588.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $660.69 / $1,023.29
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,995.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,122.02 / $1,348.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $2,754.23 / $5,888.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $1,698.24 / $2,290.87
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $977.24 / $1,479.11
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,737.80 / $2,187.76
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $1,174.90 / $6,309.57
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $676.08 / $1,380.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $371.54
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,905.46
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,348.96 / $2,344.23
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,862.09 / $3,715.35
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $2,398.83 / $7,413.10
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $1,071.52 / $10,232.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $691.83 / $1,202.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $588.84 / $1,000.00