go back

Ankle Orthosis, Supramalleolar, Custom Fabricated

Washington rates for HCPCS L1907

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

Rates data updated July 2026.

Facilitymedian $661 · 10th–90th $447$1,5850%20%10th90th$661Professionalmedian $550 · 10th–90th $309$1,1750%10%10th90th$550$5.0$20.0$100.0$500.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$831.76
Typical High
$1,698.24
Aetna
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$446.68
Typical High
$1,862.09
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$501.19
Typical High
$602.56
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$645.65
Typical High
$660.69
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$575.44
Typical High
$741.31
Cigna
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$416.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$416.87
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$891.25
Typical High
$1,905.46
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$776.25
Typical High
$1,412.54
Molina
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$512.86
Typical High
$562.34
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$645.65
Typical High
$676.08
Pacific Source
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$660.69
Typical High
$691.83
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$977.24
Typical High
$1,318.26
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$645.65
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$645.65
Typical High
$660.69
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$575.44
Typical High
$741.31
United
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$977.24
Typical High
$977.24
United
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$331.13
Typical High
$575.44
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$575.44
Typical High
$1,023.29