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Tennessee 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
$358.78 / $358.78 / $392.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$352.13 / $384.57 / $671.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$475.13 / $717.71 / $717.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$385.44 / $450.57 / $450.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.92 / $328.92 / $450.57
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,442.15 / $3,794.31 / $4,566.79
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,147.14 / $6,294.65 / $7,210.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$265.23 / $389.55 / $541.89