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Ankle Orthosis, Gauntlet, Off-the-Shelf

West 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.

Facilitymedian $55 · 10th–90th $54$590%50%10th90th$55Professionalmedian $52 · 10th–90th $43$660%50%10th90th$52$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
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$54.95
Typical High
$58.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$52.48
Typical High
$53.70
CareSource
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$125.89
Typical High
$128.82
CareSource
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$112.20
Typical High
$151.36
Cigna
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$138.04
Typical High
$138.04
Cigna
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$42.66
Typical High
$501.19
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$104.71
United
Setting
Facility
Modifier
Global
Typical Low
$38.02
Median
$44.67
Typical High
$104.71
United
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$60.26
Typical High
$87.10