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New Jersey rates for HCPCS L4050

Replace molded calf lacer, for custom fabricated orthosis only

Facilitymedian $209 · 10th–90th $209–$6170%20%40%90th$209Professionalmedian $263 · 10th–90th $200–$6170%10%20%10th90th$263$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $239.88 / $380.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $288.40
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $575.44 / $851.14
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $616.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $269.15 / $630.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $323.59 / $616.60