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Ankle Orthosis, Gauntlet, Off-the-Shelf

New Mexico rates for HCPCS L1902

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

Rates data updated October 2026.

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

$91.20

Typical negotiated rate. In New Mexico, October 2026.

Insurers have agreed to pay about $91.20 for this service. The price depends on where it is billed: about $91.20 from a physician practice, and about $437 from a hospital or other facility.

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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$91.20$57.54 to $115
FacilityA hospital or hospital-owned outpatient department$437$58.88 to $955

How much rates vary

Facilitymedian $437 · 10th to 90th $29 to $1,349Professionalmedian $91 · 10th to 90th $43 to $141
$50$100$200$500$1Kfacility $437professional $91

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$58.88
Median
$58.88
Typical High
$58.88
Aetna
Setting
Professional
Modifier
None
Typical Low
$50.12
Median
$91.20
Typical High
$91.20
Ambetter
Setting
Professional
Modifier
None
Typical Low
$19.95
Median
$19.95
Typical High
$104.71
BCBS New Mexico
Setting
Facility
Modifier
None
Typical Low
$263.03
Median
$912.01
Typical High
$1,445.44
BCBS New Mexico
Setting
Professional
Modifier
None
Typical Low
$72.44
Median
$95.50
Typical High
$114.82
Cigna
Setting
Facility
Modifier
None
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
Cigna
Setting
Professional
Modifier
None
Typical Low
$42.66
Median
$42.66
Typical High
$57.54
Molina
Setting
Professional
Modifier
None
Typical Low
$141.25
Median
$173.78
Typical High
$263.03
Providence
Setting
Facility
Modifier
None
Typical Low
$28.84
Median
$57.54
Typical High
$91.20
Providence
Setting
Professional
Modifier
None
Typical Low
$42.66
Median
$42.66
Typical High
$114.82
United
Setting
Facility
Modifier
None
Typical Low
$104.71
Median
$104.71
Typical High
$123.03
United
Setting
Professional
Modifier
None
Typical Low
$40.74
Median
$44.67
Typical High
$67.61

Where New Mexico sits

The same service costs 2.6 times more in Hawaii than in Delaware. 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.

New Mexico· 7th of 51

$91.20

HI $117DE $44.67

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.