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Pennsylvania rates for HCPCS L4040

Replace molded thigh lacer, for custom fabricated orthosis only

Facilitymedian $562 · 10th–90th $191–$7410%20%40%10th90th$562Professionalmedian $245 · 10th–90th $191–$4170%20%10th90th$245$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$190.55 / $741.31 / $741.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $239.88 / $398.11
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $467.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $354.81
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $724.44 / $1,047.13
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $331.13 / $478.63
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $239.88 / $346.74
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $741.31 / $1,071.52
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $478.63
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $630.96 / $724.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $229.09 / $501.19