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West Virginia rates for HCPCS L4090

Replace metal bands KAFO-AFO, calf or distal thigh

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.01 / $53.01 / $53.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.42 / $50.74 / $57.52
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.28 / $138.54 / $179.59
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.70 / $74.61 / $127.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.72 / $66.72 / $132.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.71 / $66.72 / $554.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.98 / $61.98 / $61.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.54 / $54.75 / $85.32