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Replacement KAFO-AFO Metal Bands, Calf or Distal Thigh

South Dakota rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Rates data updated October 2026.

How much does Replacement KAFO-AFO Metal Bands, Calf or Distal Thigh cost?

$102

Typical negotiated rate. In South Dakota, October 2026.

Insurers have agreed to pay about $102 for this service. The price depends on where it is billed: about $102 from a physician practice, and about $117 from a hospital or other facility.

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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$102$67.61 to $126
FacilityA hospital or hospital-owned outpatient department$117$100 to $132

How much rates vary

Facilitymedian $117 · 10th to 90th $89 to $191Professionalmedian $102 · 10th to 90th $46 to $145
$50$100$200$500facility $117professional $102

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$74.13
Median
$74.13
Typical High
$74.13
Aetna
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$69.18
Typical High
$83.18
Cigna
Setting
Facility
Modifier
None
Typical Low
$66.07
Median
$66.07
Typical High
$147.91
Cigna
Setting
Professional
Modifier
None
Typical Low
$117.49
Median
$144.54
Typical High
$147.91
Medica
Setting
Facility
Modifier
None
Typical Low
$89.13
Median
$117.49
Typical High
$190.55
Medica
Setting
Professional
Modifier
None
Typical Low
$40.74
Median
$64.57
Typical High
$676.08
Midlands
Setting
Professional
Modifier
None
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Midlands
Setting
Facility
Modifier
None
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
Midlands
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$120.23
Typical High
$181.97
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$87.10
Median
$102.33
Typical High
$117.49
United
Setting
Professional
Modifier
None
Typical Low
$40.74
Median
$56.23
Typical High
$85.11
Wellmark
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89

Where South Dakota sits

The same service costs 2.7 times more in Hawaii than in Delaware. 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.

South Dakota· 9th of 51

$102

HI $132DE $48.98

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.