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Elbow Orthosis (EO), Double Upright Adjustable Position Lock

Wisconsin rates for HCPCS L3740

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

Rates data updated July 2026.

Facilitymedian $1,202 · 10th–90th $955$2,2910%20%40%10th90th$1,202Professionalmedian $1,122 · 10th–90th $589$1,9950%20%10th90th$1,122$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$2,290.87
Typical High
$2,290.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$588.84
Typical High
$1,071.52
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,202.26
Typical High
$1,995.26
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,122.02
Typical High
$1,348.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$2,754.23
Typical High
$6,165.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$1,737.80
Typical High
$2,290.87
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$977.24
Typical High
$1,479.11
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,737.80
Typical High
$2,187.76
Medica
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$1,174.90
Typical High
$6,309.57
Medica
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$676.08
Typical High
$1,380.38
Molina
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$70.79
Typical High
$371.54
Network Health
Setting
Facility
Modifier
Global
Typical Low
$1,905.46
Median
$1,905.46
Typical High
$1,905.46
Network Health
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,348.96
Typical High
$2,344.23
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$977.24
Typical High
$1,479.11
Prevea360
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$1,174.90
Typical High
$1,584.89
Quartz
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$1,819.70
Typical High
$3,548.13
Quartz
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$2,454.71
Typical High
$6,456.54
Quartz
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$1,778.28
Typical High
$10,232.93
Security Health
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,096.48
Typical High
$1,096.48
United
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$691.83
Typical High
$1,202.26
United
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$588.84
Typical High
$1,148.15