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Ankle-Foot Orthosis, Prefabricated

Texas rates for HCPCS L1930

Ankle-foot orthosis (AFO), plastic or other material, prefabricated, includes fitting and adjustment

Rates data updated July 2026.

Facilitymedian $269 · 10th–90th $148$7760%10%20%10th90th$269Professionalmedian $170 · 10th–90th $129$2190%50%10th90th$170$0.2$1.0$5.0$20.0$100.0$500.0$2.0K

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
$158.49
Median
$190.55
Typical High
$380.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$165.96
Typical High
$245.47
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$269.15
Typical High
$269.15
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$3,548.13
Typical High
$4,786.30
BCBS
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$169.82
Baylor Scott & White
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$288.40
Typical High
$446.68
Christus
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$223.87
Typical High
$223.87
Cigna
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$416.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$177.83
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$1,737.80
Median
$1,737.80
Typical High
$1,737.80
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$1,905.46
Median
$1,995.26
Typical High
$1,995.26
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$269.15
Typical High
$446.68
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$309.03
Typical High
$363.08
Molina
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$194.98
Providence
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$269.15
Typical High
$446.68
Providence
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$177.83
United
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$288.40
Typical High
$363.08
United
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$158.49
Typical High
$190.55
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$363.08
Typical High
$489.78