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Ankle-Foot Orthosis, Spring Wire, Custom Fabricated

Virginia rates for HCPCS L1900

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

Rates data updated July 2026.

Facilitymedian $309 · 10th–90th $151$3890%20%40%10th90th$309Professionalmedian $182 · 10th–90th $126$3090%20%10th90th$182$0.2$2.0$20.0$200.0$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
$123.03
Median
$151.36
Typical High
$151.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$151.36
Typical High
$186.21
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$331.13
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$389.05
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$213.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$190.55
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$190.55
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$309.03
Typical High
$436.52
Medcost
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$204.17
Typical High
$302.00
Medcost
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$204.17
Typical High
$380.19
Medcost
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$165.96
Typical High
$389.05
Sentara
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$251.19
Typical High
$891.25
Sentara
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$251.19
Typical High
$891.25
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$151.36
Typical High
$416.87
United
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$151.36
Typical High
$245.47