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Replacement KAFO-AFO Metal Bands, Calf or Distal Thigh

New Hampshire rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Rates data updated July 2026.

Facilitymedian $120 · 10th–90th $66$1480%20%10th90th$120Professionalmedian $72 · 10th–90th $52$1050%20%10th90th$72$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
$66.07
Median
$66.07
Typical High
$79.43
Aetna
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$66.07
Typical High
$79.43
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$128.82
Typical High
$147.91
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
Cigna
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$87.10
Cigna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$66.07
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$190.55
United
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$52.48
Typical High
$64.57
United
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$70.79
Typical High
$104.71
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$169.82