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Ankle Orthosis, Gauntlet, Off-the-Shelf

Michigan 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?

$75.86

Typical negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $75.86 for this service. The price depends on where it is billed: about $75.86 from a physician practice, and about $148 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 8 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$75.86$53.70 to $97.72
FacilityA hospital or hospital-owned outpatient department$148$120 to $186

How much rates vary

Facilitymedian $148 · 10th to 90th $51 to $240Professionalmedian $76 · 10th to 90th $50 to $110
$50$100$200$500facility $148professional $76

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
$51.29
Median
$147.91
Typical High
$186.21
Aetna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$66.07
Typical High
$109.65
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$58.88
Typical High
$69.18
BCBS
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$269.15
Typical High
$512.86
BCBS
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$93.33
CareSource
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$112.20
Typical High
$177.83
CareSource
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$128.82
Typical High
$131.83
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
$57.54
Typical High
$112.20
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$169.82
Typical High
$190.55
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$69.18
Typical High
$109.65
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$74.13
Typical High
$112.20
United
Setting
Facility
Modifier
Global
Typical Low
$30.20
Median
$74.13
Typical High
$123.03
United
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$44.67
Typical High
$83.18

Where Michigan sits

The same service costs 2.5 times more in Hawaii than in Washington, DC. 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.

Michigan· 13th of 51

$75.86

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.