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Maryland rates for HCPCS L3640

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

Facilitymedian $23 · 10th–90th $16–$360%10%20%10th90th$23Professionalmedian $26 · 10th–90th $20–$450%10%20%10th90th$26$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $25.12 / $44.67
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $35.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $38.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $30.20
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $51.29 / $77.62
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $22.91 / $35.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $25.12 / $40.74
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $43.65