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West Virginia 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
$158.49 / $549.54 / $575.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $158.49 / $239.88
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.93 / $208.93 / $426.58
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $380.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.83 / $501.19 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $128.82 / $1,513.56
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $512.86 / $562.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $141.25 / $323.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $165.96 / $257.04