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Washington, DC rates for HCPCS L4040

Replace Molded Thigh Lacer, For Custom Fabricated Orthotic Only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.97 / $189.97 / $189.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.97 / $189.97 / $189.97
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$249.00 / $249.00 / $317.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.36 / $257.36 / $257.36
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$301.70 / $301.70 / $921.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.37 / $231.56 / $487.07