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Georgia rates for HCPCS L4050

Replace molded calf lacer, for custom fabricated orthosis only

Facilitymedian $479 · 10th–90th $219–$1,7380%10%20%10th90th$479Professionalmedian $282 · 10th–90th $214–$4900%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
$218.78 / $218.78 / $575.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $251.19 / $416.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $1,122.02 / $1,737.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $389.05 / $630.96
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
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 / $575.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $478.63 / $851.14
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $229.09 / $446.68
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $234.42 / $457.09