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Maine rates for HCPCS L3762

Elbow orthosis (EO), rigid, without joints, includes soft interface material, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.02 / $65.81 / $69.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.35 / $132.61 / $245.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.01 / $67.22 / $67.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.81 / $65.81 / $84.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.04 / $48.04 / $65.81
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.17 / $93.17 / $93.17
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.25 / $65.81 / $69.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.49 / $57.41 / $132.02