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Nebraska rates for HCPCS L3640

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

Facilitymedian $52 · 10th–90th $23–$2400%10%20%10th90th$52Professionalmedian $33 · 10th–90th $17–$1380%10%10th90th$33$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
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $33.11 / $33.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $33.11 / $218.78
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $50.12 / $50.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $57.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $60.26 / $89.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$29.51 / $56.23 / $239.88
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $25.70 / $51.29
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $57.54 / $138.04
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $128.82 / $138.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.78 / $27.54 / $53.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $25.70 / $40.74