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Kentucky rates for HCPCS L1904

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

Facilitymedian $331 · 10th–90th $240–$9550%10%20%10th90th$331Professionalmedian $295 · 10th–90th $240–$3890%20%10th90th$295$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $281.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $288.40 / $398.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $537.03 / $562.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $309.03 / $323.59
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $707.95 / $933.25
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $660.69 / $851.14
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $954.99 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $416.87 / $2,818.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $354.81 / $457.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $263.03 / $354.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $263.03 / $407.38