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Kansas rates for HCPCS L1904

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

Facilitymedian $372 · 10th–90th $170–$5750%20%10th90th$372Professionalmedian $427 · 10th–90th $240–$4470%50%10th90th$427$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$416.87 / $416.87 / $416.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $295.12 / $426.58
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $371.54 / $389.05
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $630.96
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $371.54 / $2,754.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $263.03 / $3,981.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $436.52 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $263.03 / $380.19