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Wyoming 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
Professional
Modifier
Low / Median / High Price
$281.22 / $281.22 / $439.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$490.41 / $490.41 / $490.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$490.41 / $490.41 / $490.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$313.79 / $313.79 / $637.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.07 / $229.07 / $313.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.43 / $250.53 / $278.14