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Replacement KAFO-AFO Metal Bands, Calf or Distal Thigh

Nebraska rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Rates data updated July 2026.

Facilitymedian $132 · 10th–90th $51$5370%10%10th90th$132Professionalmedian $60 · 10th–90th $48$1070%50%10th90th$60$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
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$83.18
Typical High
$83.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$60.26
Typical High
$83.18
BCBS
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$125.89
Typical High
$128.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$147.91
Cigna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$144.54
Typical High
$275.42
Medica
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$141.25
Typical High
$537.03
Medica
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$61.66
Typical High
$131.83
Midlands
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$354.81
Midlands
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
Midlands
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$323.59
Typical High
$354.81
United
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$107.15
Typical High
$131.83
United
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$60.26
Typical High
$102.33