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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
$245.47 / $309.03 / $812.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $630.96 / $724.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $295.12 / $389.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $338.84 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $245.47 / $338.84
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $467.74 / $562.34
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $323.59 / $812.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.88 / $239.88 / $239.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $302.00 / $512.86