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Arizona 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
$229.09 / $288.40 / $1,258.93
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $407.38 / $851.14
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $676.08 / $1,288.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $316.23 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $229.09 / $316.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $446.68 / $2,754.23
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $251.19 / $3,801.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $331.13 / $537.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $251.19 / $380.19