go back

West Virginia 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
Facility
Modifier
Low / Median / High Price
$608.69 / $608.69 / $608.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$567.41 / $582.54 / $763.53
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$766.84 / $1,590.58 / $2,061.87
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$765.84 / $825.83 / $1,415.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$736.22 / $736.22 / $1,550.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.44 / $736.22 / $6,498.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$492.66 / $619.79 / $979.66