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Michigan rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Facilitymedian $129 · 10th–90th $58–$4070%10%20%10th90th$129Professionalmedian $58 · 10th–90th $47–$1020%20%40%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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $57.54 / $91.20
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $309.03 / $588.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $107.15
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $69.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $66.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $57.54 / $81.28
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $194.98 / $218.78
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $83.18 / $125.89
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $66.07
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $85.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $83.18 / $138.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $48.98 / $74.13