go back

Mississippi 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
$29.34 / $29.34 / $46.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.95 / $33.46 / $46.76
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.57 / $40.57 / $40.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.57 / $40.57 / $40.57
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 / $43.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.72 / $23.01 / $23.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.48 / $24.85 / $38.99