go back

Mississippi rates for HCPCS L4050

Replace molded calf lacer, for custom fabricated orthosis only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$257.04 / $257.04 / $416.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $257.04 / $416.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $363.08 / $363.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $363.08 / $363.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$288.40 / $288.40 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $213.80 / $288.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.49 / $371.54 / $630.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $218.78 / $354.81