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Ankle Orthosis, Gauntlet, Off-the-Shelf

Montana 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 Montana, 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 $87.10 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$75.86$53.70 to $100
FacilityA hospital or hospital-owned outpatient department$87.10$74.13 to $110

How much rates vary

Facilitymedian $87 · 10th to 90th $60 to $263Professionalmedian $76 · 10th to 90th $41 to $219
$100.0$1.0K$10.0K$100.0Kfacility $87professional $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
Professional
Modifier
Global
Typical Low
$40.74
Median
$75.86
Typical High
$229.09
BCBS
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$69,183.10
Typical High
$91,201.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
Cigna
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$95.50
Typical High
$95.50
Cigna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$95.50
Typical High
$95.50
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$87.10
Typical High
$169.82
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$87.10
Typical High
$169.82
Providence
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$89.13
Typical High
$131.83
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$79.43
Typical High
$104.71
United
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$47.86
Typical High
$56.23
United
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$44.67
Typical High
$69.18

Where Montana 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.

Montana $75.86 · 16th 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.