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New Jersey rates for HCPCS L1904

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

Facilitymedian $224 · 10th–90th $186–$5620%20%40%10th90th$224Professionalmedian $295 · 10th–90th $214–$5500%10%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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $281.84 / $380.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $331.13
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $537.03 / $758.58
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $549.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $309.03 / $616.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $295.12 / $549.54