go back

Iowa rates for HCPCS L3720

Elbow orthosis (EO), double upright with forearm/arm cuffs, free motion, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$520.59 / $520.59 / $524.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.35 / $433.08 / $712.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$450.57 / $450.57 / $830.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$450.57 / $868.50 / $1,085.63
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$705.00 / $790.82 / $854.46
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$474.26 / $958.73 / $3,794.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.53 / $406.42 / $1,031.49
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$828.03 / $830.45 / $1,095.43
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$680.15 / $970.08 / $1,586.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.53 / $376.64 / $974.01
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$717.20 / $717.20 / $717.20
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$566.59 / $717.20 / $717.20