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Replacement KAFO-AFO Metal Bands, Calf or Distal Thigh

North Carolina rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Rates data updated July 2026.

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

$81.28

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $81.28 for this service. The price depends on where it is billed: about $81.28 from a physician practice, and about $93.33 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$81.28$54.95 to $93.33
FacilityA hospital or hospital-owned outpatient department$93.33$66.07 to $117

How much rates vary

Facilitymedian $93 · 10th to 90th $47 to $209Professionalmedian $81 · 10th to 90th $47 to $93
$50$100$200$500facility $93professional $81

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$93.33
Typical High
$93.33
BCBS
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$104.71
Typical High
$213.80
BCBS
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$89.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$47.86
Median
$66.07
Typical High
$70.79
Cigna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$74.13
Medcost
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$64.57
Typical High
$69.18
Medcost
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$93.33
Typical High
$154.88
United
Setting
Facility
Modifier
Global
Typical Low
$38.90
Median
$77.62
Typical High
$109.65
United
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$52.48
Typical High
$77.62
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$549.54
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$691.83
Typical High
$912.01

Where North Carolina sits

The same service costs 3.2 times more in Hawaii than in Washington, DC. 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.

North Carolina· 13th of 51

$81.28

HI $132DC $41.69

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.