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Arkansas rates for HCPCS L4055

Replace nonmolded calf lacer, for custom fabricated orthosis only

Facilitymedian $398,107 · 10th–90th $170–$891,2510%10%20%10th90th$398,107Professionalmedian $170 · 10th–90th $135–$2090%50%10th90th$170$0.2$2.0$20.0$200.0$2.0K$20.0K$200.0K

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
$169.82 / $169.82 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $169.82 / $208.93
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218,776.16 / $524,807.46 / $954,992.59
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $346.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $363.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $138.04 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $263.03 / $407.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $147.91 / $229.09