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Indiana 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
$271.42 / $271.42 / $548.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.99 / $281.86 / $323.64
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$411.29 / $411.29 / $411.29
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$433.23 / $490.81 / $548.39
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.52 / $295.10 / $407.23
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$413.49 / $603.23 / $822.59
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$466.13 / $603.23 / $740.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$321.89 / $336.03 / $548.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.30 / $245.30 / $562.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.93 / $262.16 / $370.79