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Alabama rates for HCPCS L4050

Replace Molded Calf Lacer, For Custom Fabricated Orthotic Only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$419.48 / $419.48 / $419.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.57 / $419.48 / $419.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$170.18 / $206.52 / $277.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.17 / $346.17 / $346.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$290.63 / $290.63 / $495.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.16 / $290.63 / $433.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$444.22 / $444.22 / $444.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.69 / $229.97 / $349.53