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Vermont rates for HCPCS L4055

Replace nonmolded calf lacer, for custom fabricated orthosis only

Facilitymedian $186 · 10th–90th $148–$2950%50%10th90th$186Professionalmedian $195 · 10th–90th $123–$2240%50%10th90th$195$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $194.98 / $223.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $186.21
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $389.05
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $186.21 / $263.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $251.19 / $467.74