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Replacement Molded Thigh Lacer

Washington rates for HCPCS L4040

Replace molded thigh lacer, for custom fabricated orthosis only

Rates data updated July 2026.

Facilitymedian $603 · 10th–90th $389$1,2020%20%10th90th$603Professionalmedian $513 · 10th–90th $257$9330%10%20%10th90th$513$5.0$20.0$100.0$500.0$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
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$977.24
Aetna
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$416.87
Typical High
$2,691.53
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$602.56
Typical High
$616.60
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$691.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$354.81
Typical High
$354.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$354.81
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$724.44
Typical High
$1,737.80
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$660.69
Typical High
$1,071.52
Molina
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$426.58
Typical High
$512.86
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$602.56
Typical High
$616.60
Pacific Source
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$645.65
Typical High
$645.65
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$891.25
Typical High
$1,230.27
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$602.56
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$616.60
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$537.03
Typical High
$691.83
United
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$630.96
Typical High
$758.58
United
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$269.15
Typical High
$436.52
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$281.84
Typical High
$537.03