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Wisconsin rates for HCPCS L4020

Replace quadrilateral socket brim, molded to patient model

Facilitymedian $1,175 · 10th–90th $955–$2,1380%20%40%10th90th$1,175Professionalmedian $724 · 10th–90th $501–$1,7780%20%10th90th$724$1.0$5.0$20.0$100.0$500.0$2.0K

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
$588.84 / $588.84 / $588.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $588.84 / $812.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $1,949.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,318.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $2,754.23 / $5,888.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $1,698.24 / $2,238.72
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $954.99 / $1,479.11
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,174.90 / $1,412.54
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $1,174.90 / $5,128.61
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $575.44 / $1,288.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $831.76
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $1,862.09 / $1,862.09
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,348.96 / $2,344.23
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,778.28 / $3,019.95
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $2,344.23 / $6,165.95
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $1,096.48 / $6,165.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $575.44 / $1,174.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $575.44 / $977.24