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North Dakota rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.02 / $74.02 / $74.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.76 / $70.76 / $74.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.12 / $112.47 / $115.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.13 / $119.31 / $150.02
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.72 / $74.02 / $538.29
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.53 / $55.91 / $84.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.84 / $50.75 / $84.59