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Nationwide rates for HCPCS L4050

Replace molded calf lacer, for custom fabricated orthosis only

Facilitymedian $380 · 10th–90th $214–$1,2300%20%10th90th$380Professionalmedian $275 · 10th–90th $209–$5010%20%10th90th$275$0.5$5.0$50.0$500.0$5.0K$50.0K$500.0K

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
$204.17 / $257.04 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $257.04 / $407.38
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $288.40 / $1,148.15
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $281.84 / $630.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $1,862.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $724.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $309.03 / $630.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $245.47 / $501.19

See more rates by state

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