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Wisconsin rates for HCPCS L4045

Replace nonmolded thigh lacer, for custom fabricated orthosis only

Facilitymedian $380 · 10th–90th $302–$6920%20%40%10th90th$380Professionalmedian $257 · 10th–90th $174–$5620%20%10th90th$257$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $190.55 / $323.59
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $616.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $870.96 / $1,862.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $537.03 / $707.95
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $302.00 / $467.74
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $371.54 / $489.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $371.54 / $1,949.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $213.80 / $436.52
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $213.80
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $588.84
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $426.58 / $741.31
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $575.44 / $1,148.15
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $758.58 / $2,344.23
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $338.84 / $3,019.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $218.78 / $380.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $186.21 / $323.59