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Indiana rates for HCPCS L4045

Replace nonmolded thigh lacer, for custom fabricated orthosis only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$182.91 / $182.91 / $369.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.88 / $189.95 / $198.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$291.94 / $330.75 / $369.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.28 / $225.09 / $307.27
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$277.16 / $406.51 / $554.33
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$314.12 / $406.51 / $498.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.92 / $230.92 / $369.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.57 / $230.92 / $379.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.91 / $184.37 / $272.25