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Georgia rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $50.12 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $56.23 / $95.50
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.65 / $257.04 / $398.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $89.13 / $138.04
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.20 / $91.20 / $91.20
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $91.20 / $91.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.07 / $66.07 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $48.98 / $117.49
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $109.65 / $190.55
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.62 / $50.12 / $69.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $52.48 / $104.71