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Ankle-Foot Orthosis, Spring Wire, Custom Fabricated

Illinois rates for HCPCS L1900

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

Rates data updated July 2026.

Facilitymedian $347 · 10th–90th $178$1,7780%20%10th90th$347Professionalmedian $229 · 10th–90th $162$3470%20%10th90th$229$0.2$1.0$5.0$20.0$100.0$500.0$2.0K

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
$177.83
Median
$177.83
Typical High
$346.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$177.83
Typical High
$346.74
BCBS
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$676.08
Typical High
$2,344.23
BCBS
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$269.15
Typical High
$269.15
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$229.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$346.74
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$346.74
Typical High
$426.58
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$446.68
Molina
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$275.42
United
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$281.84
Typical High
$346.74
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$169.82
Typical High
$302.00