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Massachusetts 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
$22.21 / $22.21 / $22.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.21 / $24.49 / $32.57
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.00 / $105.80 / $242.56
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.98 / $36.39 / $49.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.65 / $39.20 / $39.20
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
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.17 / $41.17 / $43.23
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.97 / $32.97 / $32.97
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.80 / $242.56 / $242.56
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.35 / $25.37 / $49.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $23.01 / $26.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.68 / $26.31 / $49.65