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Replacement KAFO-AFO Metal Bands, Calf or Distal Thigh

Minnesota rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Rates data updated July 2026.

Facilitymedian $174 · 10th–90th $87$8320%20%10th90th$174Professionalmedian $102 · 10th–90th $71$1170%50%10th90th$102$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
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$70.79
Typical High
$81.28
BCBS
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$102.33
Typical High
$147.91
BCBS
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$102.33
Typical High
$102.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$389.05
Typical High
$1,047.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$134.90
Typical High
$151.36
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$426.58
Typical High
$831.76
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$117.49
Typical High
$162.18
Medica
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$102.33
Typical High
$537.03
Medica
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$51.29
Typical High
$131.83
United
Setting
Facility
Modifier
Global
Typical Low
$0.81
Median
$50.12
Typical High
$165.96
United
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$60.26
Typical High
$144.54