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Idaho 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
$245.47 / $363.08 / $562.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $616.60 / $1,000.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $724.44 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $316.23 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $229.09 / $316.23
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $501.19 / $645.65
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $616.60 / $645.65
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $457.09 / $562.34
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $630.96 / $630.96
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $457.09 / $724.44
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $645.65 / $645.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $331.13 / $398.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $251.19 / $354.81