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Utah 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 $316 · 10th–90th $162–$5010%20%40%10th90th$316Professionalmedian $363 · 10th–90th $162–$2,8840%10%10th90th$363$50.0$100.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $302.00 / $2,884.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $316.23
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $363.08 / $478.63
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $501.19 / $501.19
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $562.34
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $645.65
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $512.86 / $776.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $251.19 / $398.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $251.19 / $398.11