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California rates for HCPCS L4045

Replace nonmolded thigh lacer, for custom fabricated orthosis only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $218.78 / $2,137.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $218.78 / $1,905.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $213.80 / $977.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $537.03
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $851.14 / $1,148.15
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $933.25 / $1,584.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $229.09 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $169.82 / $229.09
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $316.23 / $602.56
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $457.09 / $812.83
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $2,344.23 / $2,344.23
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,019.95 / $3,019.95 / $3,019.95
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $371.54 / $371.54
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.89 / $398.11 / $602.56
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $169.82 / $363.08
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $933.25 / $933.25
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $380.19 / $457.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $181.97 / $501.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $204.17 / $501.19