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Oklahoma rates for HCPCS L3640

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

Facilitymedian $26 · 10th–90th $23–$760%20%10th90th$26Professionalmedian $25 · 10th–90th $20–$330%20%10th90th$25$10.0$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
$23.99 / $23.99 / $23.99
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $25.12 / $30.90
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 / $56.23
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $32.36 / $239.88
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $25.12 / $64.57
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $33.11 / $53.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $23.44 / $33.11