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Wyoming 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
$659.80 / $659.80 / $1,031.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,150.59 / $1,150.59 / $1,150.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,150.59 / $1,150.59 / $1,150.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$736.22 / $736.22 / $1,376.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.44 / $537.44 / $736.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.26 / $587.79 / $652.57