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Louisiana rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.56 / $73.84 / $99.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.74 / $70.76 / $80.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.03 / $191.38 / $269.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.41 / $91.38 / $91.38
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.72 / $66.72 / $66.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.71 / $57.61 / $66.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.98 / $61.98 / $61.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.84 / $59.38 / $85.07