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Delaware rates for HCPCS L1904

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

Facilitymedian $331 · 10th–90th $0$3630%50%10th90th$331Professionalmedian $269 · 10th–90th $240$1,4130%20%10th90th$269$0.5$2.0$10.0$50.0$200.0$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
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $269.15 / $1,412.54
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 / $380.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.42 / $346.74 / $363.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $316.23 / $478.63