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Montana rates for HCPCS L4040

Replace molded thigh lacer, for custom fabricated orthosis only

Facilitymedian $468 · 10th–90th $331–$5890%20%40%10th90th$468Professionalmedian $347 · 10th–90th $209–$5890%10%10th90th$347$100.0$200.0$500.0$1.0K$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
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $269.15 / $537.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $501.19 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $501.19 / $501.19
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $467.74 / $912.01
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $467.74 / $912.01
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $489.78 / $630.96
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $380.19 / $588.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $288.40 / $302.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $229.09 / $354.81