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West Virginia rates for HCPCS L3640

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

Facilitymedian $26 · 10th–90th $26–$830%50%90th$26Professionalmedian $25 · 10th–90th $20–$360%20%40%10th90th$25$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $25.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $25.12 / $25.70
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $70.79
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $63.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $83.18 / $83.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $251.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $22.91 / $53.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $26.92 / $42.66