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Arizona rates for HCPCS L3640

Transfer of an orthosis from one shoe to another, Dennis Browne splint (Riveton), both shoes

Facilitymedian $42 · 10th–90th $15–$1000%10%10th90th$42Professionalmedian $26 · 10th–90th $21–$470%20%10th90th$26$0.1$0.2$1.0$5.0$20.0$100.0

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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $26.92 / $45.71
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $54.95 / $102.33
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $50.12 / $97.72
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $36.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $36.31
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $33.88 / $239.88
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $23.44 / $263.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.38 / $41.69 / $41.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $23.44 / $34.67