go back

Vermont 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
$646.61 / $646.61 / $746.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$620.97 / $620.97 / $973.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$453.31 / $620.97 / $661.98
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$620.97 / $620.97 / $973.90
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$453.31 / $620.97 / $661.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$440.70 / $784.92 / $1,531.82