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Ankle-Foot Orthosis, Spring Wire, Custom Fabricated

Hawaii 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?

$372

Typical negotiated rate. In Hawaii, October 2026.

Insurers have agreed to pay about $372 for this service. Most negotiated rates run $251 to $389.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $288 · 10th to 90th $191 to $288Professionalmedian $372 · 10th to 90th $229 to $398
$200$500facility $288professional $372

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Cigna
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$288.40
Typical High
$288.40
Cigna
Setting
Professional
Modifier
None
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
HMSA
Setting
Professional
Modifier
None
Typical Low
$371.54
Median
$371.54
Typical High
$389.05
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$223.87
Median
$371.54
Typical High
$478.63
United
Setting
Professional
Modifier
None
Typical Low
$251.19
Median
$398.11
Typical High
$398.11
University Health Alliance
Setting
Professional
Modifier
None
Typical Low
$229.09
Median
$229.09
Typical High
$229.09

Where Hawaii 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.

Hawaii· 1st of 51

$372

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.