go back

Missouri rates for HCPCS L4045

Replace nonmolded thigh lacer, for custom fabricated orthosis only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.30 / $208.30 / $277.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.95 / $215.88 / $329.50
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$397.91 / $417.81 / $1,836.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.17 / $225.09 / $321.92
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 / $168.57 / $237.85
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$198.49 / $322.07 / $1,940.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.75 / $198.51 / $483.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.36 / $198.51 / $284.10