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Kansas rates for HCPCS L4055

Replace nonmolded calf lacer, for custom fabricated orthosis only

Facilitymedian $263 · 10th–90th $98–$3390%50%10th90th$263Professionalmedian $251 · 10th–90th $138–$3240%20%40%10th90th$251$0.2$1.0$5.0$20.0$100.0$500.0$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
$251.19 / $251.19 / $251.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $173.78 / $251.19
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $302.00 / $323.59
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $323.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $346.74
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $223.87 / $1,584.89
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $162.18 / $2,754.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $263.03 / $331.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $154.88 / $223.87