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Ankle-Foot Orthosis, Spring Wire, Custom Fabricated

Maine rates for HCPCS L1900

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

Rates data updated July 2026.

Facilitymedian $372 · 10th–90th $174$4570%20%10th90th$372Professionalmedian $200 · 10th–90th $155$3160%20%10th90th$200$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$181.97
Typical High
$218.78
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$426.58
Typical High
$489.78
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$239.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$263.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$190.55
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$316.23
Typical High
$371.54
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$190.55
Typical High
$218.78
United
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$151.36
Typical High
$190.55
United
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$309.03
Typical High
$316.23