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Louisiana 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
$28.29 / $30.04 / $40.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.86 / $30.04 / $32.65
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.57 / $77.84 / $109.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.07 / $37.18 / $37.18
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
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 / $60.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.79 / $23.01 / $27.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.48 / $24.15 / $35.78