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West Virginia rates for HCPCS L1904

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

Facilitymedian $324 · 10th–90th $324–$7080%50%90th$324Professionalmedian $282 · 10th–90th $257–$4270%20%10th90th$282$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
$323.59 / $323.59 / $524.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $281.84 / $346.74
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $707.95
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $630.96
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 / $239.88 / $2,818.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $354.81 / $616.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $338.84 / $524.81