go back

Wisconsin rates for HCPCS L4040

Replace molded thigh lacer, for custom fabricated orthosis only

Facilitymedian $513 · 10th–90th $417–$9330%50%10th90th$513Professionalmedian $355 · 10th–90th $224–$7590%10%20%10th90th$355$0.5$2.0$10.0$50.0$200.0$1.0K

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
$251.19 / $251.19 / $251.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $251.19 / $407.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $851.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $575.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $1,174.90 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $724.44 / $954.99
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $416.87 / $630.96
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $501.19 / $616.60
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $501.19 / $2,454.71
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $269.15 / $562.34
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $354.81
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $575.44 / $1,000.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $758.58 / $1,445.44
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $1,023.29 / $2,884.03
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $512.86 / $3,467.37
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $269.15 / $512.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $251.19 / $426.58