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New Mexico rates for HCPCS L4050

Replace molded calf lacer, for custom fabricated orthosis only

Facilitymedian $331 · 10th–90th $151–$6310%10%10th90th$331Professionalmedian $251 · 10th–90th $209–$4170%20%10th90th$251$100.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $229.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $251.19 / $380.19
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $371.54 / $446.68
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 / $213.80 / $602.56
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $467.74 / $691.83
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $346.74 / $562.34
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $588.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $251.19 / $630.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $234.42 / $346.74