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Iowa rates for HCPCS L3640

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

Facilitymedian $52 · 10th–90th $27–$1510%20%10th90th$52Professionalmedian $28 · 10th–90th $21–$560%20%10th90th$28$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
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $38.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $28.18 / $44.67
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $57.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $60.26 / $75.86
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $63.10 / $69.18
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $66.07 / $239.88
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $31.62 / $87.10
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $58.88 / $70.79
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $87.10 / $87.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.78 / $52.48 / $123.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $25.70 / $48.98
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $48.98 / $48.98