go back

Louisiana rates for HCPCS L1904

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

Facilitymedian $447 · 10th–90th $302–$9550%20%10th90th$447Professionalmedian $288 · 10th–90th $219–$4070%20%40%10th90th$288$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
$302.00 / $302.00 / $407.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $288.40 / $407.38
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $794.33 / $1,096.48
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $380.19
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $39.81
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 / $501.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $436.52 / $724.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $251.19 / $398.11