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West Virginia 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
$276.50 / $276.50 / $276.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.76 / $276.50 / $344.89
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$358.36 / $722.52 / $936.60
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$347.88 / $385.92 / $661.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$375.73 / $383.66 / $646.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.27 / $375.73 / $2,639.67
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.14 / $310.14 / $374.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.77 / $295.95 / $445.02