go back

Rhode Island 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 (Desc Revised 1/1/2018)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.50 / $294.22 / $317.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$756.72 / $1,022.02 / $1,209.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$297.14 / $349.58 / $484.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$321.89 / $336.03 / $336.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.30 / $245.30 / $245.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$209.06 / $286.10 / $445.02