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North Dakota 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
$86.70 / $86.70 / $86.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.25 / $63.25 / $86.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.43 / $131.75 / $135.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.50 / $137.87 / $173.36
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.02 / $86.70 / $549.05
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.48 / $58.34 / $94.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$168.53 / $168.53 / $168.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.03 / $58.34 / $94.96