go back

South Carolina rates for HCPCS L4050

Replace molded calf lacer, for custom fabricated orthosis only

Facilitymedian $302 · 10th–90th $229–$6610%10%20%10th90th$302Professionalmedian $257 · 10th–90th $209–$4170%10%20%10th90th$257$50.0$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
$213.80 / $257.04 / $407.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $467.74 / $549.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $288.40 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $575.44
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $281.84
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $363.08 / $741.31
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $151.36
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $316.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $295.12 / $630.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $234.42 / $316.23