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Maine 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
$255.84 / $306.10 / $324.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$476.01 / $616.71 / $1,143.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.10 / $312.60 / $312.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$336.03 / $336.03 / $393.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.30 / $245.30 / $336.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$433.34 / $433.34 / $433.34
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$294.22 / $306.10 / $324.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.30 / $407.32 / $592.87