go back

Ankle-Foot Orthosis, Spring Wire, Custom Fabricated

Utah rates for HCPCS L1900

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

Rates data updated July 2026.

Facilitymedian $151 · 10th–90th $98$3310%20%40%10th90th$151Professionalmedian $186 · 10th–90th $98$1,4790%10%10th90th$186$50.0$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
$97.72
Median
$97.72
Typical High
$97.72
Aetna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$173.78
Typical High
$1,479.11
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$190.55
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$239.88
Typical High
$309.03
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$331.13
Typical High
$331.13
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$234.42
Typical High
$380.19
Select Health
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$338.84
Select Health
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$331.13
Typical High
$338.84
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$338.84
Typical High
$407.38
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$151.36
Typical High
$302.00
United
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$151.36
Typical High
$234.42