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Elbow Orthosis (EO), Double Upright Free Motion

New Hampshire 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?

$468

Typical negotiated rate. In New Hampshire, October 2026.

Insurers have agreed to pay about $468 for this service. The price depends on where it is billed: about $468 from a physician practice, and about $724 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$468$363 to $479
FacilityA hospital or hospital-owned outpatient department$724$479 to $794

How much rates vary

Facilitymedian $724 · 10th to 90th $447 to $891Professionalmedian $468 · 10th to 90th $331 to $631
$500$1Kfacility $724professional $468

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$316.23
Median
$407.38
Typical High
$407.38
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$676.08
Median
$776.25
Typical High
$912.01
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$467.74
Median
$467.74
Typical High
$478.63
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$46.77
Median
$46.77
Typical High
$46.77
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
Cigna
Setting
Facility
Modifier
None
Typical Low
$446.68
Median
$446.68
Typical High
$501.19
Cigna
Setting
Professional
Modifier
None
Typical Low
$331.13
Median
$331.13
Typical High
$446.68
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$323.59
Median
$630.96
Typical High
$1,023.29
United
Setting
Facility
Modifier
None
Typical Low
$478.63
Median
$478.63
Typical High
$630.96
United
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$363.08
Typical High
$588.84
Well Sense
Setting
Facility
Modifier
None
Typical Low
$724.44
Median
$724.44
Typical High
$724.44
4 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$158.49
Median
$204.17
Typical High
$204.17
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$63.10
Median
$81.28
Typical High
$81.28
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$47.86
Median
$60.26
Typical High
$60.26
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$31.62
Median
$40.74
Typical High
$40.74

Where New Hampshire 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.

New Hampshire· 30th of 51

$468

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.