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Michigan rates for HCPCS L3640

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

Facilitymedian $63 · 10th–90th $29–$2090%10%20%10th90th$63Professionalmedian $28 · 10th–90th $22–$520%20%10th90th$28$0.1$0.2$1.0$5.0$20.0$100.0$500.0

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $28.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $26.92 / $36.31
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $158.49 / $302.00
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $54.95
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $33.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $36.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $36.31 / $57.54
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $100.00 / $109.65
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $41.69 / $63.10
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $36.31
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $36.31 / $52.48
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.78 / $42.66 / $63.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $24.55 / $37.15