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Oklahoma 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
Facility
Modifier
Low / Median / High Price
$234.42 / $234.42 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $281.84 / $467.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $436.52 / $436.52
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 / $630.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $338.84 / $1,548.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $251.19 / $630.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $398.11 / $575.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $239.88 / $363.08