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Pennsylvania rates for HCPCS L1940

Ankle-foot orthosis (AFO), plastic or other material, custom fabricated

Facilitymedian $575 · 10th–90th $229–$8910%20%10th90th$575Professionalmedian $302 · 10th–90th $240–$4790%20%40%10th90th$302$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
$229.09 / $891.25 / $891.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $302.00 / $446.68
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $478.63
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
$309.03 / $457.09 / $562.34
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $371.54
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $954.99 / $1,380.38
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $562.34
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $398.11 / $562.34
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $2,570.40 / $2,570.40
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $467.74
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $229.09
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $295.12 / $446.68
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $1,096.48
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $398.11 / $575.44
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $398.11 / $562.34
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $758.58 / $870.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $275.42 / $575.44