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West Virginia rates for HCPCS L4045

Replace nonmolded thigh lacer, for custom fabricated orthosis only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.92 / $190.92 / $190.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.98 / $182.72 / $239.49
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$240.21 / $498.89 / $646.71
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.21 / $258.69 / $443.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.92 / $230.92 / $476.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.57 / $230.92 / $1,999.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.52 / $204.69 / $321.01