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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 July 2026.

Facilitymedian $741 · 10th–90th $407$8910%20%40%10th90th$741Professionalmedian $479 · 10th–90th $363$6310%20%10th90th$479$500.0$1.0K$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
$407.38
Median
$407.38
Typical High
$489.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$407.38
Typical High
$489.78
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$776.25
Typical High
$891.25
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$467.74
Typical High
$478.63
Cigna
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$524.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$446.68
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$1,174.90
United
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$416.87
Typical High
$478.63
United
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$467.74
Typical High
$630.96
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$691.83
Typical High
$1,023.29