go back

Oregon 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
Professional
Modifier
Low / Median / High Price
$22.35 / $30.50 / $146.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.33 / $36.33 / $36.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.52 / $26.52 / $26.52
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.59 / $98.72 / $128.75
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.47 / $41.79 / $50.84
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.79 / $48.30 / $53.38
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.36 / $50.84 / $55.92
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.76 / $50.84 / $52.65
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.50 / $43.62 / $53.38
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.52 / $44.52 / $55.92
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.36 / $84.56 / $178.37
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.72 / $55.92 / $55.92
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.01 / $23.01 / $29.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.85 / $23.21 / $44.29