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Montana 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
$210.89 / $294.22 / $1,149.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$541.39 / $541.39 / $541.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$336.03 / $582.10 / $582.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$336.03 / $582.10 / $582.10
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$273.12 / $554.38 / $582.10
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$431.13 / $446.58 / $582.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.88 / $244.39 / $279.76