go back

Alaska rates for HCPCS L4045

Replace nonmolded thigh lacer, for custom fabricated orthosis only

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$579.66 / $579.66 / $579.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.92 / $230.92 / $230.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.57 / $230.92 / $237.85
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.03 / $119.03 / $119.03
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.16 / $642.86 / $1,015.04
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.03 / $119.03 / $230.92
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.57 / $237.85 / $436.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$327.05 / $647.04 / $843.98