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Pennsylvania 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 $575 · 10th–90th $204–$7940%20%10th90th$575Professionalmedian $275 · 10th–90th $204–$4790%20%10th90th$275$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$204.17 / $794.33 / $794.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $275.42 / $436.52
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $501.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $316.23
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $794.33 / $1,148.15
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $354.81 / $512.86
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $380.19
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $275.42 / $389.05
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $933.25
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.71 / $346.74 / $478.63
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $363.08 / $537.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $676.08 / $776.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $251.19 / $537.03