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Massachusetts rates for HCPCS L4050

Replace molded calf lacer, for custom fabricated orthosis only

Facilitymedian $331 · 10th–90th $245–$1,6980%20%10th90th$331Professionalmedian $339 · 10th–90th $209–$5500%20%10th90th$339$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$208.93 / $251.19 / $416.87
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $575.44 / $2,570.40
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $426.58 / $630.96
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $1,000.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $331.13 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $371.54
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $3,630.78 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $741.31
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $575.44 / $2,570.40
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $426.58 / $630.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $302.00 / $630.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $354.81 / $501.19