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North Dakota 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
$723.02 / $723.02 / $723.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$690.50 / $690.50 / $723.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$929.19 / $1,098.63 / $1,125.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,152.00 / $1,163.52 / $1,463.04
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$554.05 / $723.02 / $5,297.15
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$395.91 / $531.36 / $826.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.52 / $495.79 / $826.31