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Elbow Orthosis (EO), Double Upright Free Motion

Indiana rates for HCPCS L3720

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

Rates data updated July 2026.

Facilitymedian $759 · 10th–90th $372$8910%20%40%10th90th$759Professionalmedian $398 · 10th–90th $347$6920%20%40%10th90th$398$1.0$5.0$20.0$100.0$500.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$371.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$389.05
Typical High
$630.96
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$467.74
Median
$758.58
Typical High
$954.99
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$467.74
Typical High
$758.58
CareSource
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$1,047.13
Typical High
$1,202.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$1,122.02
Cigna
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$676.08
United
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$501.19
Typical High
$758.58
United
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$371.54
Typical High
$549.54