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Connecticut rates for HCPCS L4040

Replace Molded Thigh Lacer, For Custom Fabricated Orthotic Only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$244.71 / $244.71 / $244.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.39 / $236.63 / $245.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$390.20 / $503.49 / $576.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.08 / $280.08 / $293.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$352.55 / $352.55 / $352.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.36 / $257.36 / $352.55
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$327.27 / $327.27 / $327.27
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$327.27 / $352.44 / $500.23
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.83 / $278.83 / $278.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.29 / $251.18 / $484.88