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Pennsylvania rates for HCPCS L1920

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

Facilitymedian $457 · 10th–90th $162–$6310%20%10th90th$457Professionalmedian $204 · 10th–90th $162–$3470%20%40%10th90th$204$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
$162.18 / $630.96 / $630.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $204.17 / $346.74
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $323.59 / $398.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $245.47
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $562.34 / $812.83
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $281.84 / $398.11
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $162.18
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $204.17 / $338.84
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $186.21 / $660.69
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $371.54
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $371.54 / $457.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $537.03 / $616.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $194.98 / $426.58