go back

Maryland rates for HCPCS L3730

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$406.73 / $491.36 / $776.85
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533.00 / $533.00 / $679.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$620.97 / $620.97 / $620.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$453.31 / $453.31 / $620.97
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$695.65 / $993.78 / $1,431.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$447.65 / $495.79 / $790.28
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$595.38 / $595.38 / $695.65