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Florida rates for HCPCS L1904

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

Facilitymedian $257 · 10th–90th $224–$3980%20%40%10th90th$257Professionalmedian $282 · 10th–90th $224–$4680%20%10th90th$282$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $245.47 / $281.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $288.40 / $467.74
AvMed
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $537.03
AvMed
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $501.19 / $537.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $331.13
Florida Blue
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $263.03
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $323.59 / $537.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $239.88 / $295.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $281.84 / $724.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $263.03 / $380.19
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $537.03