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Hawaii rates for HCPCS L3640

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.30 / $17.30 / $17.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.39 / $40.39 / $40.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.33 / $55.92 / $55.92
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.84 / $53.24 / $53.24
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.50 / $50.84 / $71.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.01 / $23.01 / $29.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.26 / $40.39 / $55.92
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.96 / $42.36 / $48.39