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New Hampshire rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Facilitymedian $120 · 10th–90th $66–$1450%10%20%10th90th$120Professionalmedian $79 · 10th–90th $51–$1170%20%10th90th$79$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
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $66.07 / $117.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $128.82 / $147.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $87.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $66.07
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $190.55
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $50.12 / $66.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $70.79 / $104.71
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $169.82