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Replacement KAFO-AFO Metal Bands, Calf or Distal Thigh

Louisiana rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Rates data updated July 2026.

Facilitymedian $105 · 10th–90th $60$2290%20%10th90th$105Professionalmedian $69 · 10th–90th $45$930%20%10th90th$69$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
$74.13
Median
$74.13
Typical High
$74.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$69.18
Typical High
$97.72
BCBS
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$190.55
Typical High
$269.15
BCBS
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$91.20
Typical High
$91.20
Christus
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
Cigna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$102.33
United
Setting
Facility
Modifier
Global
Typical Low
$38.02
Median
$104.71
Typical High
$138.04
United
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$58.88
Typical High
$77.62