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Replacement KAFO-AFO Metal Bands, Calf or Distal Thigh

Illinois rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Rates data updated July 2026.

Facilitymedian $105 · 10th–90th $52$5250%20%10th90th$105Professionalmedian $58 · 10th–90th $50$1170%50%10th90th$58$0.1$0.5$2.0$10.0$50.0$200.0$1.0K

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
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$104.71
Aetna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$53.70
Typical High
$104.71
BCBS
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$199.53
Typical High
$707.95
Cigna
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$67.61
Cigna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$117.49
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$134.90
Typical High
$173.78
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$131.83
Typical High
$131.83
Molina
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$85.11
United
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$83.18
Typical High
$109.65
United
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$51.29
Typical High
$91.20