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Ankle Orthosis, Supramalleolar, Custom Fabricated

Pennsylvania rates for HCPCS L1907

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

Rates data updated July 2026.

Facilitymedian $1,047 · 10th–90th $275$3,5480%10%20%10th90th$1,047Professionalmedian $324 · 10th–90th $269$6760%20%10th90th$324$0.5$5.0$50.0$500.0$5.0K$50.0K

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
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$1,047.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$316.23
Typical High
$707.95
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$588.84
Typical High
$676.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$954.99
Cigna
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$416.87
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$891.25
Typical High
$1,288.25
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$676.08
Typical High
$676.08
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$467.74
Typical High
$676.08
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$512.86
Typical High
$537.03
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$537.03
Typical High
$1,047.13
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$316.23
Typical High
$537.03
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$1,071.52
Median
$2,398.83
Typical High
$3,801.89
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$630.96
Typical High
$645.65
United
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$831.76
Typical High
$831.76
United
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$331.13
Typical High
$676.08