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Replacement KAFO Leather Cuff, Proximal Thigh

Washington rates for HCPCS L4100

Replace leather cuff KAFO, proximal thigh

Rates data updated July 2026.

Facilitymedian $151 · 10th–90th $105$3090%10%20%10th90th$151Professionalmedian $129 · 10th–90th $59$2400%10%20%10th90th$129$1.0$5.0$20.0$100.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$251.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$104.71
Typical High
$676.08
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$151.36
Typical High
$158.49
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$177.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$74.13
Typical High
$74.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$74.13
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$181.97
Typical High
$446.68
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$169.82
Typical High
$269.15
Molina
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$120.23
Typical High
$131.83
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$151.36
Typical High
$158.49
Pacific Source
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$158.49
Typical High
$158.49
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$229.09
Typical High
$316.23
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$151.36
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$158.49
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$134.90
Typical High
$177.83
United
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$158.49
Typical High
$190.55
United
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$67.61
Typical High
$114.82
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$69.18
Typical High
$134.90