go back

Elbow Orthosis (EO), Adjustable Position Lock, Off-the-Shelf

Wisconsin rates for HCPCS L3761

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

Rates data updated July 2026.

Facilitymedian $562 · 10th–90th $417$1,0230%50%10th90th$562Professionalmedian $525 · 10th–90th $204$1,1220%20%10th90th$525$0.5$2.0$10.0$50.0$200.0$1.0K

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
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$275.42
Typical High
$275.42
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$275.42
Typical High
$501.19
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$933.25
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$524.81
Typical High
$630.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$1,737.80
Typical High
$2,818.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$812.83
Typical High
$1,047.13
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$501.19
Typical High
$912.01
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$575.44
Typical High
$660.69
Medica
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$549.54
Typical High
$2,570.40
Medica
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$295.12
Typical High
$645.65
Molina
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$70.79
Typical High
$354.81
Network Health
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$691.83
Typical High
$1,445.44
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$501.19
Typical High
$912.01
Prevea360
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$549.54
Quartz
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$831.76
Typical High
$1,479.11
Quartz
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$1,148.15
Typical High
$2,630.27
Quartz
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$831.76
Typical High
$2,818.38
United
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$288.40
Typical High
$562.34
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$467.74
Typical High
$1,230.27