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Replacement Molded Thigh Lacer

Wisconsin rates for HCPCS L4040

Replace molded thigh lacer, for custom fabricated orthosis only

Rates data updated July 2026.

Facilitymedian $513 · 10th–90th $380$1,0230%50%10th90th$513Professionalmedian $479 · 10th–90th $251$8510%20%10th90th$479$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
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$251.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$416.87
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$851.14
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$575.44
Cigna
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$1,174.90
Typical High
$2,570.40
Cigna
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$741.31
Typical High
$954.99
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$416.87
Typical High
$630.96
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$501.19
Typical High
$616.60
Medica
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$501.19
Typical High
$2,454.71
Medica
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$269.15
Typical High
$562.34
Molina
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$70.79
Typical High
$354.81
Network Health
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$812.83
Typical High
$812.83
Network Health
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$575.44
Typical High
$1,000.00
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$416.87
Typical High
$630.96
Prevea360
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$501.19
Typical High
$616.60
Quartz
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$758.58
Typical High
$1,380.38
Quartz
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$1,047.13
Typical High
$2,511.89
Quartz
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$758.58
Typical High
$3,467.37
United
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$269.15
Typical High
$512.86
United
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$251.19
Typical High
$467.74