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Arizona rates for HCPCS L4050

Replace molded calf lacer, for custom fabricated orthosis only

Facilitymedian $501 · 10th–90th $162–$1,3800%10%10th90th$501Professionalmedian $257 · 10th–90th $209–$5130%20%10th90th$257$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$208.93 / $257.04 / $416.87
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $676.08 / $1,258.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $616.60 / $1,174.90
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 / $288.40
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $416.87 / $2,511.89
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $234.42 / $4,365.16
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $446.68 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $234.42 / $346.74