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Maryland rates for HCPCS L3640

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.81 / $22.21 / $39.75
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.00 / $32.00 / $34.76
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 / $26.52
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.59 / $50.84 / $73.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.74 / $23.01 / $27.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.98 / $25.37 / $40.43
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.88 / $27.88 / $35.59