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Washington, DC rates for HCPCS L1904

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

Facilitymedian $257 · 10th–90th $257–$8710%50%90th$257Professionalmedian $282 · 10th–90th $214–$4680%20%10th90th$282$200.0$500.0$1.0K

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
$257.04 / $257.04 / $257.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $281.84 / $426.58
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $446.68
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $354.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $549.54 / $1,258.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $870.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $316.23 / $616.60