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Ankle-Foot Orthosis, Spring Wire, Custom Fabricated

Montana rates for HCPCS L1900

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

Rates data updated July 2026.

Facilitymedian $324 · 10th–90th $214$4070%20%40%10th90th$324Professionalmedian $257 · 10th–90th $98$6310%20%10th90th$257$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$181.97
Typical High
$1,479.11
BCBS
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$323.59
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$346.74
Typical High
$346.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$346.74
Typical High
$346.74
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$323.59
Typical High
$630.96
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$323.59
Typical High
$630.96
Providence
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$309.03
Typical High
$457.09
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$263.03
Typical High
$346.74
United
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$190.55
Typical High
$199.53
United
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$151.36
Typical High
$234.42