go back

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
$616.60 / $616.60 / $707.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $602.56 / $1,412.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,202.26 / $4,265.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $616.60 / $1,122.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $724.44 / $1,202.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $616.60 / $616.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $457.09 / $616.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $933.25 / $5,248.07
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $588.84 / $6,606.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $954.99 / $954.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $549.54 / $851.14