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Ankle-Foot Orthosis, Spring Wire, Custom Fabricated

Rhode Island rates for HCPCS L1900

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

Rates data updated October 2026.

How much does Ankle-Foot Orthosis, Spring Wire, Custom Fabricated cost?

$200

Typical negotiated rate. In Rhode Island, October 2026.

Insurers have agreed to pay about $200 for this service. The price depends on where it is billed: about $200 from a physician practice, and about $661 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$200$174 to $214
FacilityA hospital or hospital-owned outpatient department$661$525 to $759

How much rates vary

Facilitymedian $661 · 10th to 90th $417 to $832Professionalmedian $200 · 10th to 90th $138 to $295
$200$500facility $661professional $200

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$213.80
Typical High
$213.80
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$100.00
Median
$107.15
Typical High
$107.15
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$39.81
Median
$42.66
Typical High
$42.66
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$30.20
Median
$31.62
Typical High
$31.62
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$19.95
Median
$21.38
Typical High
$21.38
BCBS Rhode Island
Setting
Facility
Modifier
None
Typical Low
$524.81
Median
$707.95
Typical High
$831.76
BCBS Rhode Island
Setting
Professional
Modifier
None
Typical Low
$141.25
Median
$199.53
Typical High
$309.03
Cigna
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Cigna
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$138.04
Typical High
$190.55
United
Setting
Facility
Modifier
None
Typical Low
$416.87
Median
$416.87
Typical High
$416.87
United
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$190.55
Typical High
$295.12

Where Rhode Island sits

The same service costs 2.7 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Rhode Island· 24th of 51

$200

HI $372DE $138

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.