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Replacement KAFO-AFO Metal Bands, Calf or Distal Thigh

Pennsylvania 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?

$51.29

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $51.29 for this service. The price depends on where it is billed: about $51.29 from a physician practice, and about $138 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 9 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$51.29$46.77 to $72.44
FacilityA hospital or hospital-owned outpatient department$138$48.98 to $214

How much rates vary

Facilitymedian $138 · 10th to 90th $43 to $363Professionalmedian $51 · 10th to 90th $43 to $102
$100$1K$10Kfacility $138professional $51

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
$42.66
Median
$42.66
Typical High
$162.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$51.29
Typical High
$91.20
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$158.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$66.07
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$162.18
Typical High
$234.42
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$104.71
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$72.44
Typical High
$104.71
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$42.66
Median
$42.66
Typical High
$162.18
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$48.98
Typical High
$107.15
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$63.10
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$245.47
Typical High
$398.11
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$97.72
Typical High
$100.00
United
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$138.04
Typical High
$138.04
United
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$51.29
Typical High
$109.65

Where Pennsylvania 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.

Pennsylvania· 47th of 51

$51.29

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.