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Virginia rates for HCPCS L4050

Replace molded calf lacer, for custom fabricated orthosis only

Facilitymedian $479 · 10th–90th $229–$5890%20%40%10th90th$479Professionalmedian $282 · 10th–90th $209–$4570%20%10th90th$282$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
$190.55 / $229.09 / $588.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $239.88 / $407.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $501.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $588.84
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $323.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $288.40 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $288.40
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $478.63 / $660.69
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $309.03 / $467.74
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $316.23 / $630.96
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $309.03 / $588.84
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $389.05 / $1,288.25
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $389.05 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $245.47 / $478.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $234.42 / $380.19