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Utah rates for HCPCS L3762

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

Facilitymedian $39 · 10th–90th $33–$1200%20%40%10th90th$39Professionalmedian $66 · 10th–90th $33–$1510%20%10th90th$66$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $38.90 / $38.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $63.10 / $257.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $66.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $47.86 / $66.07
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $87.10 / $112.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $120.23 / $120.23
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $85.11 / $128.82
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $120.23 / $120.23
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $120.23 / $141.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $52.48 / $56.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $52.48 / $91.20