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Iowa 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
Facility
Modifier
Low / Median / High Price
$381.04 / $381.04 / $403.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.27 / $294.22 / $492.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$321.89 / $336.03 / $600.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.84 / $635.63 / $794.53
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$506.98 / $545.69 / $551.32
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$342.80 / $647.77 / $2,563.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.39 / $282.45 / $744.18
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$598.51 / $600.26 / $744.18
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$491.60 / $701.19 / $1,147.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.21 / $275.83 / $715.76
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$518.41 / $518.41 / $518.41
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$409.54 / $518.41 / $518.41