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Massachusetts rates for HCPCS L3640

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.88 / $21.88 / $21.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $25.12 / $46.77
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $52.48 / $239.88
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $38.02 / $52.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.31 / $36.31 / $36.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $26.30 / $36.31
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $4,897.79 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $44.67 / $67.61
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $33.11 / $33.11
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $52.48 / $239.88
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $38.90 / $52.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $26.92 / $63.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $28.84 / $44.67