Replacement calf lacer for custom orthosis

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Replace molded calf lacer

Payers reporting HCPCS L4050

Payer pricing summary

Low

$164

Average

$596

Median

$524

High

$1.3k

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +8 other terms	361	$484	$606	$389	64%	—	$236 – $5.4k
2	UnitedHealthcare fee schedule · outpatient · +10 other terms	358	$479	$500	$154	31%	—	$224 – $1.9k
3	Humana fee schedule · outpatient · +9 other terms	319	$474	$731	$765	105%	—	$259 – $3.6k
4	Blue Cross Blue Shield fee schedule · outpatient · +8 other terms	219	$484	$687	$392	57%	—	$0 – $2.3k
5	WellCare fee schedule · outpatient · +4 other terms	208	$489	$523	$134	26%	—	$465 – $1.2k
6	Devoted fee schedule · outpatient · +3 other terms	165	$474	$479	$18	4%	—	$456 – $645
7	Molina fee schedule · outpatient · +4 other terms	140	$699	$687	$264	38%	—	$291 – $1.4k
8	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$488	$485	$23	5%	—	$474 – $651
9	Cigna fee schedule · outpatient · +6 other terms	102	$489	$569	$183	32%	—	$456 – $1.6k
10	Anthem fee schedule · outpatient · +6 other terms	80	$474	$680	$673	99%	—	$274 – $3.8k
11	Kaiser fee schedule · outpatient · +5 other terms	64	$484	$901	$695	77%	—	$456 – $4.2k
12	Superior Healthplan fee schedule · outpatient	40	$498	$498	$2	0%	—	$465 – $498
13	Clover fee schedule · outpatient · +2 other terms	37	$620	$555	$64	12%	—	$474 – $633
14	Oscar fee schedule · outpatient · +4 other terms	36	$498	$587	$197	34%	—	$465 – $1.1k
15	Ambetter facility · fee schedule · outpatient · +6 other terms	35	$910	$956	$167	18%	—	$465 – $1.2k
16	Optum fee schedule · outpatient · +2 other terms	33	$474	$626	$248	40%	—	$456 – $1.2k
17	Caresource fee schedule · outpatient · +5 other terms	28	$474	$522	$154	30%	—	$274 – $781
18	Regence facility · fee schedule · outpatient · +3 other terms	19	$493	$503	$20	4%	—	$474 – $547
19	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$569	$555	$27	5%	—	$484 – $569
20	Bcbs Tx fee schedule · outpatient	18	$465	$465	—	—	—	$465 – $465
21	Medicare fee schedule · outpatient · +1 other terms	18	$456	$457	$4	1%	—	$456 – $465
22	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$505	$584	$144	25%	—	$275 – $798
23	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$460	$459	$107	23%	—	$224 – $538
24	Wellmark fee schedule · both · +1 other terms	13	$499	$495	$21	4%	—	$368 – $499
25	Aetna Better Health fee schedule · outpatient · +2 other terms	12	$267	$350	$98	28%	—	$267 – $465

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