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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 July 2026.

Facilitymedian $269 · 10th–90th $151$1,6600%20%10th90th$269Professionalmedian $166 · 10th–90th $138$2950%20%10th90th$166$0.2$1.0$5.0$20.0$100.0$500.0$2.0K

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
$154.88
Median
$165.96
Typical High
$269.15
Aetna
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$162.18
Typical High
$295.12
BCBS
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$269.15
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$218.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$190.55
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$1,659.59
Median
$1,659.59
Typical High
$1,659.59
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$1,949.84
Median
$2,290.87
Typical High
$2,290.87
United
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$173.78
Typical High
$346.74
United
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$162.18
Typical High
$223.87