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Hawaii rates for HCPCS L3760

Elbow orthosis (EO), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$294.22 / $294.22 / $306.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$425.18 / $425.18 / $425.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$336.03 / $588.72 / $588.72
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$535.20 / $560.41 / $560.41
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.12 / $535.20 / $749.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$373.00 / $425.18 / $588.72
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$357.62 / $445.91 / $509.42