go back

Alaska rates for HCPCS L3761

Elbow orthosis (EO), with adjustable position locking joint(s), prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $346.74 / $467.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $371.54 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $275.42 / $398.11
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $354.81 / $512.86
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $549.54 / $1,737.80
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $524.81 / $549.54
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $524.81 / $537.03
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $354.81 / $549.54
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $371.54 / $794.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $239.88 / $281.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $416.87 / $1,348.96