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Hip Orthosis, Von Rosen Type, Custom Fabricated

Utah rates for HCPCS L1630

Hip orthosis (HO), abduction control of hip joints, semi-flexible (Von Rosen type), custom fabricated

Rates data updated July 2026.

How much does Hip Orthosis, Von Rosen Type, Custom Fabricated cost?

$115

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $115 for this service. The price depends on where it is billed: about $115 from a physician practice, and about $95.50 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 7 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$115$85.11 to $195
FacilityA hospital or hospital-owned outpatient department$95.50$61.66 to $191

How much rates vary

Facilitymedian $95 · 10th to 90th $62 to $191Professionalmedian $115 · 10th to 90th $62 to $912
$50.0$100.0$200.0$500.0$1.0Kfacility $95professional $115

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
$61.66
Median
$61.66
Typical High
$61.66
Aetna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$85.11
Typical High
$912.01
Cigna
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$120.23
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$138.04
Typical High
$181.97
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$190.55
Typical High
$190.55
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$134.90
Typical High
$229.09
Select Health
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Select Health
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$190.55
Typical High
$208.93
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$194.98
Typical High
$251.19
United
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$95.50
Typical High
$173.78
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$95.50
Typical High
$144.54

Where Utah sits

The same service costs 3.3 times more in Minnesota than in Washington, DC. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Utah $115 · 30th of 51
MN $257DC $77.62

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.