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Ankle-Foot Orthosis, Spring Wire, Custom Fabricated

Tennessee 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?

$170

Typical negotiated rate. In Tennessee, October 2026.

Insurers have agreed to pay about $170 for this service. The price depends on where it is billed: about $170 from a physician practice, and about $191 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$170$151 to $263
FacilityA hospital or hospital-owned outpatient department$191$191 to $191

How much rates vary

Facilitymedian $191 · 10th to 90th $155 to $191Professionalmedian $170 · 10th to 90th $138 to $1,950
$100$200$500$1K$2Kfacility $191professional $170

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
Aetna
Setting
Professional
Modifier
None
Typical Low
$151.36
Median
$154.88
Typical High
$181.97
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$75.86
Median
$75.86
Typical High
$89.13
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$30.20
Median
$30.90
Typical High
$35.48
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$22.39
Median
$22.91
Typical High
$26.92
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$15.14
Median
$15.49
Typical High
$17.78
BCBS Tennessee
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$263.03
Typical High
$263.03
Cigna
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$190.55
Typical High
$199.53
Cigna
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$138.04
Typical High
$190.55
Lucent Health
Setting
Professional
Modifier
None
Typical Low
$1,949.84
Median
$2,344.23
Typical High
$2,344.23
United
Setting
Facility
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$173.78
United
Setting
Professional
Modifier
None
Typical Low
$107.15
Median
$162.18
Typical High
$199.53

Where Tennessee 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.

Tennessee· 42nd of 51

$170

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.