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Replacement KAFO-AFO Metal Bands, Calf or Distal Thigh

New Jersey 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?

$54.95

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $54.95 for this service. The price depends on where it is billed: about $54.95 from a physician practice, and about $41.69 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 5 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$54.95$47.86 to $81.28
FacilityA hospital or hospital-owned outpatient department$41.69$41.69 to $66.07

How much rates vary

Facilitymedian $42 · 10th to 90th $42 to $123Professionalmedian $55 · 10th to 90th $43 to $120
$50$100$200$500facility $42professional $55

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
$41.69
Median
$41.69
Typical High
$41.69
Aetna
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$50.12
Typical High
$81.28
Cigna
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$66.07
Typical High
$123.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$66.07
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$117.49
Typical High
$162.18
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
United
Setting
Facility
Modifier
Global
Typical Low
$42.66
Median
$66.07
Typical High
$123.03
United
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$64.57
Typical High
$117.49

Where New Jersey 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.

New Jersey· 44th of 51

$54.95

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.