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Washington rates for HCPCS L3761

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

Facilitymedian $603 · 10th–90th $389–$1,2880%20%10th90th$603Professionalmedian $398 · 10th–90th $245–$6460%10%20%10th90th$398$1.0$5.0$20.0$100.0$500.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $851.14
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $363.08 / $588.84
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $660.69 / $851.14
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $524.81 / $524.81
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $602.56
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $380.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $371.54
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $776.25 / $1,513.56
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $724.44 / $1,202.26
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $512.86 / $562.34
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $537.03 / $537.03
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $812.83 / $1,071.52
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $524.81
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $602.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $794.33 / $794.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $288.40 / $467.74
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $407.38 / $812.83