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Vermont 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
$24.81 / $24.81 / $28.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.33 / $36.33 / $36.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.54 / $26.52 / $26.52
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.33 / $36.33 / $36.33
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.54 / $26.52 / $26.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.01 / $23.01 / $29.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.59 / $30.12 / $58.78