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Alaska rates for HCPCS L4050

Replace molded calf lacer, for custom fabricated orthosis only

Facilitymedian $288 · 10th–90th $151–$9550%20%40%10th90th$288Professionalmedian $339 · 10th–90th $245–$1,1220%10%20%10th90th$339$100.0$200.0$500.0$1.0K$2.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $316.23 / $851.14
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $1,174.90
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $457.09 / $954.99
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $954.99 / $1,698.24
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $977.24 / $1,000.00
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $977.24 / $1,000.00
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $660.69
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $288.40 / $537.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $302.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $489.78 / $2,454.71