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Minnesota rates for HCPCS L3762

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.62 / $81.91 / $81.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.99 / $63.25 / $82.53
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.99 / $117.89 / $164.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.31 / $112.00 / $117.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.81 / $364.16 / $844.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.50 / $144.69 / $173.36
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.20 / $349.40 / $796.40
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.50 / $136.50 / $140.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.95 / $117.89 / $549.05
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.03 / $58.68 / $141.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.37 / $140.44 / $168.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.03 / $56.36 / $118.38