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Vermont rates for HCPCS L4040

Replace molded thigh lacer, for custom fabricated orthosis only

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $275.42 / $363.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $354.81 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $257.04 / $363.08
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $489.78 / $616.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $234.42 / $309.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $354.81 / $1,047.13