go back

Missouri 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
$61.43 / $61.43 / $81.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.59 / $63.32 / $97.17
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.03 / $88.01 / $153.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.34 / $123.21 / $541.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.32 / $64.01 / $94.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.81 / $65.81 / $383.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.04 / $48.04 / $71.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.73 / $94.97 / $549.05
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.54 / $58.54 / $142.62
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.08 / $109.08 / $109.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.44 / $140.44 / $168.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.14 / $58.54 / $89.09