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Arizona rates for HCPCS L1907

Ankle orthosis (AO), supramalleolar with straps, with or without interface/pads, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.69 / $337.37 / $596.86
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$509.52 / $509.52 / $562.46
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.73 / $627.59 / $1,134.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$470.51 / $579.09 / $745.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$419.48 / $419.48 / $419.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.22 / $306.22 / $786.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.06 / $442.14 / $3,157.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$273.08 / $302.14 / $491.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$273.08 / $302.14 / $455.14