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Ankle Orthosis, Gauntlet, Off-the-Shelf

Delaware rates for HCPCS L1902

Ankle orthosis (AO), ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf

Rates data updated October 2026.

How much does Ankle Orthosis, Gauntlet, Off-the-Shelf cost?

$44.67

Typical negotiated rate. In Delaware, October 2026.

Insurers have agreed to pay about $44.67 for this service. The price depends on where it is billed: about $43.65 from a physician practice, and about $57.54 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$43.65$42.66 to $57.54
FacilityA hospital or hospital-owned outpatient department$57.54$43.65 to $57.54

How much rates vary

Facilitymedian $58 · 10th to 90th $44 to $138Professionalmedian $44 · 10th to 90th $43 to $71
$50$100facility $58professional $44

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$43.65
Median
$43.65
Typical High
$43.65
Aetna
Setting
Professional
Modifier
None
Typical Low
$42.66
Median
$43.65
Typical High
$61.66
Cigna
Setting
Facility
Modifier
None
Typical Low
$57.54
Median
$57.54
Typical High
$138.04
Cigna
Setting
Professional
Modifier
None
Typical Low
$42.66
Median
$42.66
Typical High
$57.54
United
Setting
Facility
Modifier
None
Typical Low
$43.65
Median
$43.65
Typical High
$51.29
United
Setting
Professional
Modifier
None
Typical Low
$40.74
Median
$52.48
Typical High
$79.43
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Highmark BCBS
Setting
Professional
Modifier
KX · Policy requirements met
Typical Low
$74.13
Median
$79.43
Typical High
$85.11

Where Delaware sits

The same service costs 2.6 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Delaware· 51st of 51

$44.67

HI $117DE $44.67

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.