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Hawaii rates for HCPCS L4050

Replace molded calf lacer, for custom fabricated orthosis only

Facilitymedian $288 · 10th–90th $229–$8320%50%10th90th$288Professionalmedian $331 · 10th–90th $229–$1,0720%10%20%10th90th$331$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $257.04 / $346.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $1,000.00 / $1,318.26
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,122.02
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,071.52 / $1,230.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $288.40 / $295.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $354.81 / $1,174.90