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Wisconsin rates for HCPCS L4210

Repair of orthotic device, repair or replace minor parts

Facilitymedian $65 · 10th–90th $20–$1000%20%10th90th$65Professionalmedian $20 · 10th–90th $20–$580%50%90th$20$10.0$20.0$50.0$100.0$200.0

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
$19.95 / $19.95 / $19.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $56.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $57.54 / $57.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $87.10 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $33.88 / $38.90
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $50.12
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $81.28 / $104.71
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $29.51 / $89.13
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.55 / $28.84 / $28.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $58.88 / $70.79
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $30.90 / $31.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $25.12 / $75.86