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Pennsylvania rates for HCPCS L3640

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

Facilitymedian $63 · 10th–90th $20$810%20%10th90th$63Professionalmedian $26 · 10th–90th $20$470%20%10th90th$26$0.1$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$19.95 / $81.28 / $81.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $25.12 / $38.02
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $51.29
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $51.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $36.31
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $67.61 / $97.72
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $51.29
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $36.31 / $51.29
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $19.95
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $25.12 / $36.31
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $72.44 / $100.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $69.18
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $51.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $63.10 / $72.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $25.12 / $51.29