go back

Kentucky rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.97 / $54.78 / $56.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.06 / $53.31 / $56.81
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.34 / $106.59 / $112.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.67 / $59.58 / $61.97
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.94 / $143.90 / $169.32
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.26 / $127.91 / $175.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.72 / $66.72 / $132.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.71 / $66.72 / $554.40
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.70 / $67.93 / $84.91
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.98 / $61.98 / $61.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.45 / $50.80 / $70.26