go back

Missouri 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
$395.22 / $395.22 / $526.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$385.10 / $409.59 / $625.16
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$754.95 / $792.70 / $3,484.85
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$370.55 / $463.84 / $611.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$450.57 / $450.57 / $450.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.92 / $328.92 / $480.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$395.22 / $611.07 / $3,794.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.04 / $376.64 / $917.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.17 / $376.64 / $628.59