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Connecticut rates for HCPCS L1904

Ankle orthosis (AO), ankle gauntlet or similar, with or without joints, custom fabricated

Facilitymedian $347 · 10th–90th $331–$6760%50%10th90th$347Professionalmedian $309 · 10th–90th $234–$4680%10%20%10th90th$309$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $302.00 / $467.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $724.44 / $870.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $338.84 / $707.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $239.88
ConnectiCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $630.96
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $512.86 / $707.95
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $302.00 / $363.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $338.84 / $588.84