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Indiana rates for HCPCS L3640

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

Facilitymedian $54 · 10th–90th $26–$660%20%40%10th90th$54Professionalmedian $26 · 10th–90th $23–$430%50%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
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $25.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $25.70 / $41.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $53.70 / $66.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $27.54 / $54.95
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $67.61 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $53.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $45.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.78 / $28.84 / $42.66
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $25.70 / $37.15