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Ankle Orthosis, Gauntlet, Off-the-Shelf

Louisiana rates for HCPCS L1902

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

Rates data updated July 2026.

Facilitymedian $79 · 10th–90th $45$2000%20%10th90th$79Professionalmedian $65 · 10th–90th $38$850%20%10th90th$65$0.1$0.5$2.0$10.0$50.0$200.0

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
$34.67
Median
$69.18
Typical High
$69.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$64.57
Typical High
$87.10
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$89.13
Typical High
$123.03
BCBS
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$177.83
Typical High
$245.47
BCBS
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Christus
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$79.43
Typical High
$79.43
Cigna
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$42.66
Typical High
$87.10
United
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$97.72
Typical High
$123.03
United
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$53.70
Typical High
$69.18