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Missouri rates for HCPCS L3640

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

Facilitymedian $43 · 10th–90th $26–$1050%20%10th90th$43Professionalmedian $28 · 10th–90th $22–$460%20%40%10th90th$28$0.1$0.2$1.0$5.0$20.0$100.0

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
$26.92 / $26.92 / $30.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $26.92 / $44.67
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $186.21
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $27.54 / $48.98
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $31.62 / $52.48
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 / $36.31
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $41.69 / $239.88
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $25.70 / $263.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.38 / $42.66 / $42.66
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $25.12 / $39.81