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Rhode Island 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
$22.21 / $27.95 / $30.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.89 / $97.08 / $114.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.34 / $28.63 / $44.69
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
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.01 / $23.01 / $23.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.47 / $25.37 / $42.28