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Massachusetts rates for HCPCS L3761

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$237.12 / $237.12 / $237.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.12 / $284.54 / $369.55
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$417.72 / $1,317.49 / $2,563.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.21 / $407.54 / $522.66
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,136.16 / $1,381.38 / $1,772.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$455.27 / $831.00 / $1,242.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$375.73 / $375.73 / $383.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.27 / $375.73 / $635.63
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$433.34 / $433.34 / $455.01
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$327.91 / $327.91 / $344.90
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,113.23 / $2,563.00 / $2,563.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.31 / $276.23 / $522.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.04 / $295.95 / $522.66