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North Carolina rates for HCPCS L4050

Replace molded calf lacer, for custom fabricated orthosis only

Facilitymedian $407 · 10th–90th $209–$1,1750%20%10th90th$407Professionalmedian $339 · 10th–90th $209–$4070%20%10th90th$339$0.5$5.0$50.0$500.0$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
$407.38 / $407.38 / $407.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $316.23 / $407.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $389.05
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $288.40 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $363.08
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $234.42 / $309.03
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $407.38 / $691.83
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $234.42 / $380.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $234.42 / $346.74
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $2,570.40
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $4,677.35