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Connecticut rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.52 / $57.52 / $57.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.60 / $57.52 / $59.73
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.73 / $118.36 / $135.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.97 / $61.97 / $64.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.72 / $66.72 / $66.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.71 / $48.71 / $66.72
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.93 / $76.93 / $76.93
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.93 / $78.70 / $111.39
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.72 / $67.72 / $67.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.98 / $61.98 / $61.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.06 / $59.05 / $93.69