go back

Iowa 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
$194.98 / $234.42 / $758.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $177.83 / $524.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.83 / $177.83 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $363.08 / $457.09
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $323.59 / $354.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $371.54 / $1,479.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $190.55 / $524.81
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $363.08 / $426.58
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $354.81 / $354.81
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $524.81 / $524.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.65 / $234.42 / $457.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $158.49 / $288.40
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $302.00 / $302.00