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Idaho rates for HCPCS L4050

Replace molded calf lacer, for custom fabricated orthosis only

Facilitymedian $490 · 10th–90th $269–$7080%20%10th90th$490Professionalmedian $347 · 10th–90th $209–$6310%10%10th90th$347$50.0$100.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $338.84 / $489.78
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $537.03 / $912.01
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $630.96 / $630.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $288.40
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $467.74 / $630.96
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $537.03 / $575.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $416.87 / $489.78
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $549.54 / $549.54
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $602.56
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $575.44 / $575.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $269.15 / $446.68
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $234.42 / $354.81