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Washington rates for HCPCS L1900

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

Facilitymedian $339 · 10th–90th $224–$8130%20%10th90th$339Professionalmedian $224 · 10th–90th $145–$4900%10%20%10th90th$224$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $537.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $181.97 / $295.12
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $323.59 / $323.59
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $380.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $190.55
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $446.68 / $954.99
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $398.11 / $707.95
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $257.04 / $281.84
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $323.59 / $338.84
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $331.13 / $676.08
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $489.78 / $676.08
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $323.59
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $323.59
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $380.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $416.87 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $162.18 / $288.40
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $288.40 / $512.86