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Elbow Orthosis (EO), Rigid without Joints, Off-the-Shelf

South Dakota rates for HCPCS L3762

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

Rates data updated July 2026.

Facilitymedian $33 · 10th–90th $33$1320%50%90th$33Professionalmedian $93 · 10th–90th $63$1700%10%20%10th90th$93$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$33.11
Typical High
$33.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$81.28
Typical High
$100.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$131.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$169.82
Medica
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$117.49
Typical High
$223.87
Medica
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$79.43
Typical High
$588.84
Midlands
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$128.82
Typical High
$128.82
Midlands
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$131.83
Typical High
$131.83
Midlands
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$213.80
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$120.23
Typical High
$158.49
United
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$61.66
Typical High
$87.10
United
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$81.28
Typical High
$138.04
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$114.82