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Missouri 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
$619.51 / $619.51 / $825.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$510.78 / $642.04 / $979.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,183.41 / $1,242.58 / $5,462.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$581.95 / $604.33 / $957.42
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 / $661.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$550.23 / $953.73 / $5,297.15
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$410.76 / $590.39 / $1,438.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$410.76 / $578.41 / $958.16