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Ankle-Foot Orthosis, Prefabricated

Utah rates for HCPCS L1930

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

Rates data updated July 2026.

Facilitymedian $132 · 10th–90th $85$2880%20%40%10th90th$132Professionalmedian $178 · 10th–90th $102$7590%10%20%10th90th$178$50.0$100.0$200.0$500.0$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
$85.11
Median
$85.11
Typical High
$85.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$169.82
Typical High
$1,548.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$177.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$177.83
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$213.80
Typical High
$275.42
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$288.40
Typical High
$288.40
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$208.93
Typical High
$346.74
Select Health
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$295.12
Select Health
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$295.12
Typical High
$316.23
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$295.12
Typical High
$380.19
United
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$151.36
Typical High
$269.15
United
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$131.83
Typical High
$204.17