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Rhode Island 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
$289.12 / $363.75 / $392.46
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$935.57 / $1,263.61 / $1,495.98
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.37 / $432.20 / $598.40
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 / $419.48 / $419.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.08 / $330.12 / $550.20