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New Hampshire rates for HCPCS L3640

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

Facilitymedian $51 · 10th–90th $29–$620%20%40%10th90th$51Professionalmedian $35 · 10th–90th $22–$480%20%10th90th$35$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
$28.84 / $28.84 / $34.67
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $28.18 / $43.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $54.95 / $63.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $27.54 / $27.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $36.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $36.31
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $81.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.45 / $22.91 / $26.92
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $26.92 / $44.67
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $72.44