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Replacement KAFO-AFO Metal Bands, Calf or Distal Thigh

Missouri rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Rates data updated July 2026.

Facilitymedian $107 · 10th–90th $59$2090%20%10th90th$107Professionalmedian $68 · 10th–90th $51$1580%20%10th90th$68$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
$67.61
Median
$67.61
Typical High
$77.62
Aetna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$70.79
Typical High
$537.03
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$131.83
Typical High
$467.74
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$61.66
Typical High
$123.03
BCBS
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$131.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$100.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$66.07
Medica
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$102.33
Typical High
$537.03
Medica
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$64.57
Typical High
$676.08
United
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$107.15
Typical High
$131.83
United
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$60.26
Typical High
$102.33