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

Utah rates for HCPCS L3762

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

Rates data updated July 2026.

Facilitymedian $100 · 10th–90th $34$1200%20%40%10th90th$100Professionalmedian $63 · 10th–90th $33$2450%20%10th90th$63$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
$33.88
Median
$33.88
Typical High
$120.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$63.10
Typical High
$257.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
Cigna
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$47.86
Typical High
$66.07
Molina
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$87.10
Typical High
$112.20
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$120.23
Typical High
$120.23
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$85.11
Typical High
$128.82
Select Health
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Select Health
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$117.49
Typical High
$120.23
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$120.23
Typical High
$141.25
United
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$52.48
Typical High
$109.65
United
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$52.48
Typical High
$87.10