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Montana rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Facilitymedian $100 · 10th–90th $68–$1260%20%40%10th90th$100Professionalmedian $76 · 10th–90th $42–$1230%10%10th90th$76$50.0$100.0$200.0$500.0

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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $70.79 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $107.15 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $107.15 / $107.15
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $100.00 / $194.98
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $100.00 / $194.98
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $102.33 / $151.36
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $81.28 / $128.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $63.10 / $66.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $51.29 / $77.62