go back

Connecticut rates for HCPCS L3640

Transfer Of An Orthosis From One Shoe To Another Dennis Browne Splint (Riveton) Both Shoes (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.71 / $24.71 / $24.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.13 / $24.30 / $24.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.40 / $50.84 / $58.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.25 / $27.25 / $29.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.33 / $36.33 / $36.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.52 / $26.52 / $26.52
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.04 / $33.04 / $33.04
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.04 / $33.04 / $46.77
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.97 / $32.97 / $32.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.18 / $19.18 / $23.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.46 / $25.37 / $48.96