go back

Tennessee rates for HCPCS L4050

Replace molded calf lacer, for custom fabricated orthosis only

Facilitymedian $355 · 10th–90th $229–$2,5700%20%10th90th$355Professionalmedian $229 · 10th–90th $204–$4070%50%10th90th$229$0.5$2.0$10.0$50.0$200.0$1.0K$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
$208.93 / $229.09 / $363.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $229.09 / $389.05
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $380.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $288.40
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $2,570.40
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,677.35 / $4,677.35
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $251.19 / $380.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $229.09 / $331.13