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Ankle-Foot Orthosis, Spring Wire, Custom Fabricated

Arizona rates for HCPCS L1900

Ankle-foot orthosis (AFO), spring wire, dorsiflexion assist calf band, custom fabricated

Rates data updated October 2026.

How much does Ankle-Foot Orthosis, Spring Wire, Custom Fabricated cost?

$155

Typical negotiated rate. In Arizona, October 2026.

Insurers have agreed to pay about $155 for this service. The price depends on where it is billed: about $151 from a physician practice, and about $347 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$151$138 to $302
FacilityA hospital or hospital-owned outpatient department$347$191 to $589

How much rates vary

Facilitymedian $347 · 10th to 90th $100 to $1,585Professionalmedian $151 · 10th to 90th $138 to $1,950
$100$200$500$1Kfacility $347professional $151

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$138.04
Typical High
$138.04
BCBS Arizona
Setting
Facility
Modifier
None
Typical Low
$91.20
Median
$416.87
Typical High
$630.96
BCBS Arizona
Setting
Professional
Modifier
None
Typical Low
$263.03
Median
$302.00
Typical High
$549.54
Cigna
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Cigna
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$138.04
Typical High
$190.55
Medica
Setting
Facility
Modifier
None
Typical Low
$147.91
Median
$346.74
Typical High
$1,584.89
Medica
Setting
Professional
Modifier
None
Typical Low
$141.25
Median
$194.98
Typical High
$1,949.84
United
Setting
Facility
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$173.78
United
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$151.36
Typical High
$229.09
4 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$27.54
Median
$27.54
Typical High
$27.54
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$20.42
Median
$20.42
Typical High
$20.42
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$13.80
Median
$13.80
Typical High
$13.80

Where Arizona 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.

Arizona· 48th of 51

$155

HI $372DE $138

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.