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Lower Extremity Orthosis Addition, Lightweight Composite

Hawaii rates for HCPCS L2755

Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only

Rates data updated July 2026.

Facilitymedian $89 · 10th–90th $69$1320%20%40%10th90th$89Professionalmedian $170 · 10th–90th $52$1780%20%40%10th90th$170$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
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$81.28
Typical High
$93.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$131.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$154.88
Typical High
$208.93
HMSA
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$177.83
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$169.82
Typical High
$234.42
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$79.43
Typical High
$89.13
United
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$114.82
Typical High
$208.93