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Utah 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

Facilitymedian $275 · 10th–90th $158–$5500%20%40%10th90th$275Professionalmedian $324 · 10th–90th $158–$1,2300%10%10th90th$324$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $158.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $309.03 / $1,230.27
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $338.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $407.38 / $549.54
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $549.54 / $549.54
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $398.11 / $602.56
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $549.54 / $562.34
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $562.34 / $660.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $239.88 / $275.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $245.47 / $426.58