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Michigan rates for HCPCS L4050

Replace molded calf lacer, for custom fabricated orthosis only

Facilitymedian $631 · 10th–90th $282–$1,9950%20%10th90th$631Professionalmedian $282 · 10th–90th $209–$5010%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
$281.84 / $281.84 / $281.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $263.03 / $380.19
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,479.11 / $2,884.03
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $524.81
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
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 / $281.84 / $398.11
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $933.25 / $1,047.13
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $398.11 / $602.56
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $407.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $407.38 / $630.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $234.42 / $354.81