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Minnesota rates for HCPCS L4050

Replace molded calf lacer, for custom fabricated orthosis only

Facilitymedian $550 · 10th–90th $347–$3,6310%20%10th90th$550Professionalmedian $501 · 10th–90th $251–$5750%50%10th90th$501$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
$346.74 / $346.74 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $281.84 / $380.19
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $501.19 / $645.65
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $501.19 / $501.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,862.09 / $4,466.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $630.96 / $724.44
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,862.09 / $3,630.78
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $776.25
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $501.19 / $2,511.89
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $234.42 / $588.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.72 / $229.09 / $758.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $275.42 / $691.83