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Oregon rates for HCPCS L4090

Replace Metal Bands Kafo-Afo, Calf Or Distal Thigh

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.51 / $81.30 / $357.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.72 / $66.72 / $66.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.71 / $48.71 / $66.72
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.88 / $215.20 / $280.66
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.02 / $104.69 / $135.54
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.77 / $127.41 / $142.32
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.35 / $121.99 / $135.54
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.74 / $135.54 / $135.54
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.72 / $111.38 / $142.32
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.71 / $118.68 / $149.09
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.92 / $225.38 / $475.50
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.56 / $149.09 / $149.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.98 / $61.98 / $61.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.30 / $50.75 / $96.84