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Idaho rates for HCPCS L3720

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$378.84 / $631.39 / $754.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$450.57 / $450.57 / $603.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.92 / $450.57 / $480.33
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$232.24 / $631.39 / $861.28
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$775.15 / $818.22 / $861.28
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $643.42 / $775.15
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$754.17 / $841.09 / $1,261.64
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.90 / $602.90 / $904.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$326.64 / $359.73 / $575.48