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California rates for HCPCS L4050

Replace molded calf lacer, for custom fabricated orthosis only

Facilitymedian $269 · 10th–90th $214–$1,2300%20%10th90th$269Professionalmedian $282 · 10th–90th $214–$2,3990%20%10th90th$282$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
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $2,691.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $281.84 / $2,398.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $269.15 / $1,230.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $281.84 / $891.25
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $912.01 / $1,445.44
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $1,148.15 / $2,344.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $309.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $288.40
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $416.87 / $758.58
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $616.60 / $1,000.00
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $2,570.40
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,677.35 / $4,677.35
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $467.74
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $501.19 / $758.58
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $549.54
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $1,174.90
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $426.58 / $575.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $229.09 / $630.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $281.84 / $645.65