go back

Maryland rates for HCPCS L1900

Ankle Foot Orthosis Spring Wire Dorsiflexion Assist Calf Band Custom-Fabricated

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.39 / $150.27 / $237.59
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.00 / $163.00 / $207.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.91 / $189.91 / $189.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.63 / $138.63 / $189.91
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.75 / $303.93 / $437.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.90 / $151.62 / $241.68
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.08 / $182.08 / $212.75