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Replacement KAFO-AFO Metal Bands, Calf or Distal Thigh

Hawaii rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Rates data updated October 2026.

How much does Replacement KAFO-AFO Metal Bands, Calf or Distal Thigh cost?

$132

Typical negotiated rate. In Hawaii, October 2026.

Insurers have agreed to pay about $132 for this service. Most negotiated rates run $102 to $138.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $102 · 10th to 90th $66 to $102Professionalmedian $132 · 10th to 90th $79 to $141
$100facility $102professional $132

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$41.69
Median
$41.69
Typical High
$41.69
Cigna
Setting
Facility
Modifier
None
Typical Low
$66.07
Median
$102.33
Typical High
$102.33
Cigna
Setting
Professional
Modifier
None
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
HMSA
Setting
Professional
Modifier
None
Typical Low
$131.83
Median
$131.83
Typical High
$138.04
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$131.83
Typical High
$169.82
United
Setting
Professional
Modifier
None
Typical Low
$89.13
Median
$141.25
Typical High
$141.25
University Health Alliance
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$79.43
Typical High
$79.43

Where Hawaii sits

The same service costs 2.7 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Hawaii· 1st of 51

$132

HI $132DE $48.98

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.