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Ankle-Foot Orthosis, Spring Wire, Custom Fabricated

New Hampshire rates for HCPCS L1900

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

Rates data updated July 2026.

Facilitymedian $363 · 10th–90th $200$4470%20%40%10th90th$363Professionalmedian $219 · 10th–90th $138$3160%20%10th90th$219$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
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$239.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$199.53
Typical High
$239.88
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$389.05
Typical High
$446.68
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$186.21
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
$575.44
United
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$158.49
Typical High
$194.98
United
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$213.80
Typical High
$316.23
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$512.86