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Replacement KAFO-AFO Metal Bands, Calf or Distal Thigh

Montana rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Rates data updated October 2026.

How much does Replacement KAFO-AFO Metal Bands, Calf or Distal Thigh cost?

$107

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $107 for this service. The price depends on where it is billed: about $105 from a physician practice, and about $107 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$105$79.43 to $107
FacilityA hospital or hospital-owned outpatient department$107$105 to $5,888

How much rates vary

Facilitymedian $107 · 10th to 90th $74 to $6,026Professionalmedian $105 · 10th to 90th $51 to $126
$50$100$200$500$1K$2K$5Kfacility $107professional $105

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$53.70
Typical High
$117.49
Cigna
Setting
Facility
Modifier
None
Typical Low
$74.13
Median
$107.15
Typical High
$107.15
Cigna
Setting
Professional
Modifier
None
Typical Low
$87.10
Median
$107.15
Typical High
$107.15
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$77.62
Median
$128.82
Typical High
$6,025.60
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$104.71
Median
$128.82
Typical High
$6,309.57
Providence
Setting
Facility
Modifier
None
Typical Low
$66.07
Median
$107.15
Typical High
$107.15
Providence
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$79.43
Typical High
$107.15
United
Setting
Professional
Modifier
None
Typical Low
$46.77
Median
$51.29
Typical High
$85.11

Where Montana sits

The same service costs 2.7 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Montana· 8th of 51

$107

HI $132DE $48.98

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.