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Ankle Orthosis, Gauntlet, Off-the-Shelf

Indiana rates for HCPCS L1902

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

Rates data updated July 2026.

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

$54.95

Typical negotiated rate. In Indiana, July 2026.

Insurers have agreed to pay about $54.95 for this service. The price depends on where it is billed: about $53.70 from a physician practice, and about $91.20 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$53.70$44.67 to $75.86
FacilityA hospital or hospital-owned outpatient department$91.20$63.10 to $93.33

How much rates vary

Facilitymedian $91 · 10th to 90th $45 to $229Professionalmedian $54 · 10th to 90th $43 to $102
$0.1$1.0$10.0$100.0facility $91professional $54

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$131.83
Typical High
$295.12
Aetna
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$51.29
Typical High
$109.65
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$72.44
Typical High
$120.23
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$91.20
Typical High
$114.82
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$54.95
Typical High
$91.20
CareSource
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$120.23
Typical High
$138.04
CareSource
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$120.23
Typical High
$128.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$57.54
Typical High
$91.20
Cigna
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$42.66
Typical High
$79.43
United
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$56.23
Typical High
$91.20
United
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$44.67
Typical High
$67.61

Where Indiana sits

The same service costs 2.5 times more in Hawaii than in Washington, DC. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Indiana $54.95 · 37th of 51
HI $107DC $42.66

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.