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Arizona 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
$214.08 / $339.90 / $482.76
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$535.20 / $535.20 / $535.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.91 / $429.57 / $776.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$297.27 / $396.36 / $540.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$375.73 / $375.73 / $375.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.27 / $274.27 / $635.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$235.49 / $358.79 / $2,563.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$224.03 / $244.39 / $394.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.04 / $244.39 / $394.61