go back

Texas rates for HCPCS L1990

Ankle Foot Orthosis 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
$224.26 / $228.65 / $233.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$215.46 / $233.05 / $431.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,456.92 / $5,821.21 / $8,577.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.99 / $238.99 / $299.01
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$502.18 / $502.18 / $502.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$313.79 / $313.79 / $313.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.07 / $229.07 / $313.79
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,191.42 / $2,738.27 / $3,180.46
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,766.55 / $3,856.95 / $4,491.68
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.74 / $349.97 / $502.18
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.74 / $457.90 / $638.97
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.80 / $502.18 / $1,152.49
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.74 / $335.54 / $502.18
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.07 / $229.07 / $334.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.36 / $301.61 / $359.42
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$300.85 / $308.99 / $502.18