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Ankle-Foot Orthosis, Single Upright with Stop

Texas 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 $309 · 10th–90th $182$7080%10%10th90th$309Professionalmedian $195 · 10th–90th $170$3160%50%10th90th$195$0.5$2.0$10.0$50.0$200.0$1.0K

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
$181.97
Median
$190.55
Typical High
$234.42
Aetna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$194.98
Typical High
$323.59
BCBS
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Christus
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$416.87
Typical High
$416.87
Cigna
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$245.47
Typical High
$616.60
Cigna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$245.47
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$2,137.96
Median
$2,137.96
Typical High
$2,137.96
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$2,570.40
Median
$3,162.28
Typical High
$3,162.28
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$316.23
Typical High
$575.44
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$398.11
Typical High
$512.86
Molina
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$239.88
Providence
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$309.03
Typical High
$588.84
Providence
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$245.47
United
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$331.13
Typical High
$457.09
United
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$234.42
Typical High
$281.84
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$416.87
Typical High
$562.34