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Oklahoma rates for HCPCS L4040

Replace molded thigh lacer, for custom fabricated orthosis only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$228.65 / $228.65 / $336.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.18 / $228.65 / $245.12
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 / $352.55 / $352.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$148.11 / $299.77 / $2,469.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.94 / $231.17 / $478.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.94 / $229.42 / $329.14