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New York rates for HCPCS L1920

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

Facilitymedian $275 · 10th–90th $182–$7760%10%20%10th90th$275Professionalmedian $245 · 10th–90th $178–$5890%20%10th90th$245$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $338.84 / $478.63
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $208.93 / $346.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $851.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $245.47 / $645.65
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $354.81 / $354.81
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $575.44
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $707.95 / $1,659.59
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $426.58 / $812.83
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $239.88
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $251.19 / $269.15
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $407.38 / $407.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $229.09 / $1,202.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $281.84 / $691.83
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $251.19 / $263.03
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $251.19 / $269.15