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New York rates for HCPCS L1980

Ankle-foot orthosis (AFO), single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar 'BK' orthosis), custom fabricated

Facilitymedian $302 · 10th–90th $200–$8510%20%10th90th$302Professionalmedian $240 · 10th–90th $186–$6610%20%10th90th$240$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
$158.49 / $371.54 / $524.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $218.78 / $354.81
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $954.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $776.25
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $389.05 / $389.05
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $389.05
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $575.44
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $776.25 / $1,819.70
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $478.63 / $891.25
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $263.03
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $281.84 / $295.12
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $457.09 / $457.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $239.88 / $1,258.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $309.03 / $776.25
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $281.84 / $288.40
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $281.84 / $295.12