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Montana rates for HCPCS L3640

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

Facilitymedian $51 · 10th–90th $35–$650%20%40%10th90th$51Professionalmedian $32 · 10th–90th $17–$650%10%10th90th$32$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $28.84 / $43.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $54.95 / $54.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $54.95 / $54.95
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $51.29 / $100.00
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $51.29 / $100.00
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $48.98 / $63.10
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $54.95 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $26.92 / $28.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $23.44 / $35.48