go back

Alaska rates for HCPCS L1990

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$734.22 / $734.22 / $734.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$313.79 / $313.79 / $313.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.07 / $313.79 / $334.52
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.74 / $161.74 / $161.74
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$607.02 / $814.25 / $1,285.65
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.74 / $161.74 / $313.79
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.07 / $334.52 / $637.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$414.25 / $819.56 / $1,068.99