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Nevada rates for HCPCS L4050

Replace Molded Calf Lacer, For Custom Fabricated Orthotic Only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$211.77 / $211.77 / $244.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.36 / $211.77 / $248.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$620.13 / $620.13 / $620.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.36 / $283.29 / $620.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$290.63 / $290.63 / $456.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.16 / $290.63 / $409.85
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$344.86 / $496.10 / $806.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$444.22 / $444.22 / $444.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.68 / $232.04 / $386.73