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Utah rates for HCPCS L4040

Replace molded thigh lacer, for custom fabricated orthosis only

Facilitymedian $302 · 10th–90th $148–$4790%20%40%10th90th$302Professionalmedian $347 · 10th–90th $148–$2,6920%10%10th90th$347$50.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $275.42 / $2,691.53
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $354.81
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $346.74 / $457.09
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $478.63 / $478.63
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $537.03
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $630.96
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $489.78 / $724.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $229.09 / $309.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $229.09 / $389.05