go back

Utah rates for HCPCS L1902

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

Facilitymedian $62 · 10th–90th $38–$690%20%10th90th$62Professionalmedian $72 · 10th–90th $35–$2400%10%10th90th$72$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
$38.02 / $58.88 / $69.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $72.44 / $239.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $57.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $66.07 / $85.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $89.13 / $89.13
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $100.00
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $109.65
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $91.20 / $134.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $44.67 / $51.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $44.67 / $79.43