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Ankle Orthosis, Gauntlet, Off-the-Shelf

Minnesota 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?

$89.13

Typical negotiated rate. In Minnesota, July 2026.

Insurers have agreed to pay about $89.13 for this service. The price depends on where it is billed: about $89.13 from a physician practice, and about $155 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$89.13$72.44 to $97.72
FacilityA hospital or hospital-owned outpatient department$155$89.13 to $339

How much rates vary

Facilitymedian $155 · 10th to 90th $66 to $741Professionalmedian $89 · 10th to 90th $54 to $112
$50$100$200$500$1Kfacility $155professional $89

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
$63.10
Median
$63.10
Typical High
$63.10
Aetna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$63.10
Typical High
$131.83
BCBS
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$131.83
BCBS
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$89.13
Typical High
$89.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$338.84
Typical High
$933.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$117.49
Typical High
$131.83
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$371.54
Typical High
$741.31
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$141.25
Medica
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$89.13
Typical High
$467.74
Medica
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$58.88
Typical High
$104.71
United
Setting
Facility
Modifier
Global
Typical Low
$0.72
Median
$44.67
Typical High
$147.91
United
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$52.48
Typical High
$125.89

Where Minnesota 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.

Minnesota· 4th of 51

$89.13

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.