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Ankle Orthosis, Gauntlet, Off-the-Shelf

Virginia 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?

$54.95

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $54.95 for this service. The price depends on where it is billed: about $54.95 from a physician practice, and about $105 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 8 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$54.95$52.48 to $72.44
FacilityA hospital or hospital-owned outpatient department$105$70.79 to $107

How much rates vary

Facilitymedian $105 · 10th to 90th $52 to $129Professionalmedian $55 · 10th to 90th $43 to $107
$0.1$1.0$10.0$100.0$1.0K$10.0Kfacility $105professional $55

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
$42.66
Median
$52.48
Typical High
$97.72
Aetna
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$52.48
Typical High
$91.20
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$114.82
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$114.82
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$56.23
Typical High
$74.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$57.54
Typical High
$57.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$42.66
Typical High
$57.54
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$107.15
Typical High
$151.36
Medcost
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$70.79
Typical High
$104.71
Medcost
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$69.18
Typical High
$123.03
Medcost
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$57.54
Typical High
$134.90
Sentara
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$87.10
Typical High
$309.03
Sentara
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$87.10
Typical High
$309.03
United
Setting
Facility
Modifier
Global
Typical Low
$30.20
Median
$44.67
Typical High
$123.03
United
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$52.48
Typical High
$87.10

Where Virginia 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.

Virginia $54.95 · 36th 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.