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Indiana 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
$370.83 / $370.83 / $749.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$370.83 / $385.10 / $406.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$591.90 / $670.57 / $749.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$365.48 / $463.84 / $640.09
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$598.09 / $824.16 / $1,123.85
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$636.85 / $824.16 / $1,011.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$450.57 / $450.57 / $749.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.92 / $450.57 / $768.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.82 / $359.73 / $536.22