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New Hampshire rates for HCPCS L1990

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

Facilitymedian $646 · 10th–90th $355–$7760%20%40%10th90th$646Professionalmedian $389 · 10th–90th $257–$6030%20%10th90th$389$200.0$500.0$1.0K$2.0K

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
$354.81 / $354.81 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $354.81 / $562.34
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $691.83 / $794.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $316.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $467.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $316.23
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $1,023.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $263.03 / $398.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $380.19 / $562.34
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $912.01