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South Carolina rates for HCPCS L1902

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

Facilitymedian $46 · 10th–90th $32–$1150%20%10th90th$46Professionalmedian $54 · 10th–90th $43–$950%10%20%10th90th$54$50.0$100.0$200.0$500.0

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $44.67
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $53.70 / $95.50
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $93.33 / $138.04
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $93.33 / $109.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $57.54 / $61.66
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $104.71
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $63.10
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $79.43 / $158.49
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $28.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $63.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $53.70 / $123.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $45.71 / $61.66