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Wisconsin rates for HCPCS L1920

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

Facilitymedian $501 · 10th–90th $407–$9120%50%10th90th$501Professionalmedian $339 · 10th–90th $182–$7590%10%10th90th$339$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $251.19 / $354.81
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $831.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $467.74 / $549.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $1,174.90 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $724.44 / $954.99
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $407.38 / $630.96
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $616.60 / $776.25
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $489.78 / $2,089.30
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $245.47 / $537.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $213.80
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $575.44 / $1,000.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $758.58 / $1,230.27
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $1,000.00 / $2,089.30
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $363.08 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $229.09 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $245.47 / $407.38