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Arizona rates for HCPCS L3740

Elbow orthosis (EO), double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$583.91 / $628.38 / $1,033.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$412.43 / $1,489.91 / $2,693.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,031.08 / $1,374.77 / $1,873.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$736.22 / $736.22 / $736.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.44 / $537.44 / $1,365.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$379.47 / $1,049.67 / $6,310.18
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$530.73 / $587.79 / $885.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.26 / $587.79 / $885.43