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Ankle-Foot Orthosis, Single Upright with Stop

Hawaii rates for HCPCS L1920

Ankle-foot orthosis (AFO), single upright with static or adjustable stop (Phelps or Perlstein type), custom fabricated

Rates data updated July 2026.

Facilitymedian $245 · 10th–90th $195$3090%20%40%10th90th$245Professionalmedian $398 · 10th–90th $145$4170%50%10th90th$398$200.0$500.0

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
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$257.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$245.47
Typical High
$309.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$363.08
Typical High
$489.78
HMSA
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$416.87
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$398.11
Typical High
$562.34
United
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$257.04
United
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$302.00
Typical High
$489.78