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Ankle-Foot Orthosis, Spring Wire, Custom Fabricated

Texas rates for HCPCS L1900

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

Rates data updated July 2026.

Facilitymedian $295 · 10th–90th $158$1,0000%10%10th90th$295Professionalmedian $182 · 10th–90th $138$2630%50%10th90th$182$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
$173.78
Median
$181.97
Typical High
$223.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$181.97
Typical High
$229.09
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$3,548.13
Typical High
$4,786.30
BCBS
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$186.21
Christus
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$398.11
Typical High
$398.11
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$467.74
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
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$295.12
Typical High
$489.78
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$338.84
Typical High
$398.11
Molina
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$213.80
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$1,479.11
Median
$1,479.11
Typical High
$1,479.11
Providence
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$295.12
Typical High
$489.78
Providence
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$190.55
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$316.23
Typical High
$398.11
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$181.97
Typical High
$218.78
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$398.11
Typical High
$537.03