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Missouri rates for HCPCS L1900

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

Facilitymedian $257 · 10th–90th $166–$6920%20%10th90th$257Professionalmedian $182 · 10th–90th $138–$2950%50%10th90th$182$0.2$1.0$5.0$20.0$100.0$500.0

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $190.55
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $177.83 / $295.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $1,122.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $186.21 / $295.12
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $323.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $190.55
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $257.04 / $1,584.89
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $158.49 / $1,949.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $257.04 / $257.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $151.36 / $245.47