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Indiana rates for HCPCS L4050

Replace molded calf lacer, for custom fabricated orthosis only

Facilitymedian $501 · 10th–90th $245–$5750%20%40%10th90th$501Professionalmedian $257 · 10th–90th $214–$4070%20%40%10th90th$257$0.5$2.0$10.0$50.0$200.0$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
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $245.47 / $389.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $501.19 / $630.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $281.84 / $501.19
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $602.56 / $691.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $436.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $309.03 / $407.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $245.47 / $354.81