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Elbow Orthosis (EO), Double Upright Free Motion

Montana rates for HCPCS L3720

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

Rates data updated October 2026.

How much does Elbow Orthosis (EO), Double Upright Free Motion cost?

$759

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $759 for this service. The price depends on where it is billed: about $741 from a physician practice, and about $759 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$741$363 to $759
FacilityA hospital or hospital-owned outpatient department$759$741 to $41,687

How much rates vary

Facilitymedian $759 · 10th to 90th $501 to $42,658Professionalmedian $741 · 10th to 90th $79 to $832
$100$500$2K$10K$50Kfacility $759professional $741

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$234.42
Median
$389.05
Typical High
$758.58
Cigna
Setting
Facility
Modifier
None
Typical Low
$501.19
Median
$758.58
Typical High
$758.58
Cigna
Setting
Professional
Modifier
None
Typical Low
$616.60
Median
$758.58
Typical High
$758.58
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$549.54
Median
$912.01
Typical High
$42,657.95
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$741.31
Median
$851.14
Typical High
$44,668.36
Providence
Setting
Facility
Modifier
None
Typical Low
$446.68
Median
$758.58
Typical High
$758.58
Providence
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$562.34
Typical High
$758.58
United
Setting
Professional
Modifier
None
Typical Low
$331.13
Median
$363.08
Typical High
$602.56

Where Montana sits

The same service costs 4.6 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Montana· 4th of 51

$759

HI $1,514DE $331

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.