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Minnesota rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Facilitymedian $117 · 10th–90th $74–$7410%20%10th90th$117Professionalmedian $102 · 10th–90th $52–$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $70.79 / $91.20
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $102.33 / $131.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $102.33 / $102.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $380.19 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $134.90 / $151.36
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $380.19 / $741.31
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $158.49
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $102.33 / $537.03
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $51.29 / $131.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.81 / $50.12 / $165.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $60.26 / $144.54