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New Jersey 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
$17.30 / $17.30 / $17.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.30 / $22.13 / $28.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.33 / $36.33 / $50.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.52 / $26.52 / $60.38
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.45 / $46.77 / $66.59
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.39 / $50.84 / $50.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.53 / $23.01 / $50.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.08 / $25.37 / $50.84