go back

Arizona rates for HCPCS L3702

Elbow orthosis (EO), without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$179.03 / $179.03 / $179.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.61 / $169.87 / $472.26
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.14 / $293.10 / $529.91
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.83 / $270.44 / $368.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.75 / $176.75 / $176.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.03 / $129.03 / $367.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.10 / $176.76 / $1,474.48
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.41 / $141.11 / $225.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.54 / $141.11 / $212.57