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Replacement KAFO-AFO Metal Bands, Calf or Distal Thigh

Indiana rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Rates data updated July 2026.

Facilitymedian $105 · 10th–90th $50$1290%20%40%10th90th$105Professionalmedian $55 · 10th–90th $49$930%50%10th90th$55$0.1$0.5$2.0$10.0$50.0$200.0

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
$50.12
Median
$50.12
Typical High
$50.12
Aetna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$52.48
Typical High
$93.33
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$104.71
Typical High
$128.82
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$61.66
Typical High
$104.71
CareSource
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$138.04
Typical High
$158.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$158.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$95.50
United
Setting
Facility
Modifier
Global
Typical Low
$38.90
Median
$66.07
Typical High
$104.71
United
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$51.29
Typical High
$75.86