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Colorado rates for HCPCS L4055

Replace nonmolded calf lacer, for custom fabricated orthosis only

Facilitymedian $295 · 10th–90th $170–$3720%20%40%10th90th$295Professionalmedian $170 · 10th–90th $138–$2630%20%10th90th$170$0.2$1.0$5.0$20.0$100.0$500.0

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 / $295.12 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $169.82 / $251.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $346.74 / $660.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $181.97 / $229.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $316.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $309.03 / $794.33
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $309.03 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $162.18 / $302.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $151.36 / $309.03