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Kentucky rates for HCPCS L4055

Replace nonmolded calf lacer, for custom fabricated orthosis only

Facilitymedian $186 · 10th–90th $135–$5370%10%20%10th90th$186Professionalmedian $162 · 10th–90th $135–$2190%20%10th90th$162$100.0$200.0$500.0$1.0K

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
$154.88 / $154.88 / $158.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $158.49 / $218.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $309.03 / $323.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $177.83 / $181.97
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $407.38 / $524.81
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $380.19 / $478.63
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $537.03 / $537.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $239.88 / $1,621.81
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $199.53 / $257.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $147.91 / $199.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $151.36 / $229.09