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North Carolina rates for HCPCS L3640

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.84 / $45.84 / $79.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.35 / $45.84 / $45.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.69 / $77.65 / $95.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.34 / $39.27 / $41.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.33 / $36.33 / $45.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.52 / $36.00 / $60.38
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.99 / $45.84 / $59.59
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.00 / $33.00 / $38.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.00 / $93.80 / $100.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.89 / $23.01 / $26.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.35 / $25.88 / $40.98
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.81 / $242.56 / $242.56
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.20 / $381.30 / $381.30