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Utah rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Facilitymedian $62 · 10th–90th $32–$1020%20%40%10th90th$62Professionalmedian $71 · 10th–90th $32–$5370%10%10th90th$71$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $32.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $61.66 / $537.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $66.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $66.07
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $74.13 / $95.50
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $102.33 / $102.33
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $117.49
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $134.90
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $104.71 / $154.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $50.12 / $66.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $51.29 / $81.28