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Massachusetts rates for HCPCS L3730

Elbow orthosis (EO), double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$578.94 / $578.94 / $578.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$510.78 / $578.94 / $746.09
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$818.35 / $2,097.11 / $6,293.94
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$485.44 / $824.88 / $1,293.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,406.39 / $1,711.04 / $2,203.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.42 / $1,021.49 / $1,021.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$620.97 / $766.44 / $928.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$453.31 / $620.97 / $1,152.00
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,072.82 / $1,072.82 / $1,126.46
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$651.82 / $651.82 / $651.82
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,097.11 / $6,293.94 / $6,293.94
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$440.70 / $661.04 / $1,293.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$440.70 / $661.04 / $1,293.99