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Tibial Fracture Orthosis, Semi-Rigid, Prefabricated

Michigan rates for HCPCS L2114

Ankle-foot orthosis (AFO), fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment

Rates data updated October 2026.

How much does Tibial Fracture Orthosis, Semi-Rigid, Prefabricated cost?

$603

Typical negotiated rate. In Michigan, October 2026.

Insurers have agreed to pay about $603 for this service. The price depends on where it is billed: about $603 from a physician practice, and about $1,175 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$603$437 to $759
FacilityA hospital or hospital-owned outpatient department$1,175$407 to $2,239

How much rates vary

Facilitymedian $1,175 · 10th to 90th $407 to $3,311Professionalmedian $603 · 10th to 90th $355 to $776
$500$1K$2K$5Kfacility $1,175professional $603

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$446.68
Median
$758.58
Typical High
$758.58
Aetna
Setting
Professional
Modifier
None
Typical Low
$446.68
Median
$446.68
Typical High
$758.58
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$218.78
Median
$218.78
Typical High
$380.19
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$89.13
Median
$89.13
Typical High
$151.36
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$66.07
Median
$66.07
Typical High
$114.82
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$44.67
Median
$44.67
Typical High
$75.86
BCBS Michigan
Setting
Facility
Modifier
None
Typical Low
$912.01
Median
$2,238.72
Typical High
$4,265.80
BCBS Michigan
Setting
Professional
Modifier
None
Typical Low
$724.44
Median
$758.58
Typical High
$758.58
CareSource
Setting
Facility
Modifier
None
Typical Low
$426.58
Median
$426.58
Typical High
$426.58
Cigna
Setting
Facility
Modifier
None
Typical Low
$407.38
Median
$407.38
Typical High
$407.38
Cigna
Setting
Professional
Modifier
None
Typical Low
$295.12
Median
$407.38
Typical High
$812.83
Health Alliance Plan
Setting
Facility
Modifier
None
Typical Low
$436.52
Median
$1,479.11
Typical High
$1,621.81
Health Alliance Plan
Setting
Professional
Modifier
None
Typical Low
$436.52
Median
$588.84
Typical High
$776.25
Health Alliance Plan
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$218.78
Median
$218.78
Typical High
$218.78
Health Alliance Plan
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
Health Alliance Plan
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Health Alliance Plan
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$43.65
Median
$43.65
Typical High
$43.65
Priority Health
Setting
Facility
Modifier
None
Typical Low
$407.38
Median
$407.38
Typical High
$407.38
Priority Health
Setting
Professional
Modifier
None
Typical Low
$295.12
Median
$407.38
Typical High
$724.44
United
Setting
Facility
Modifier
None
Typical Low
$436.52
Median
$758.58
Typical High
$891.25
United
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$354.81
Typical High
$501.19
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
BCBS Michigan
Setting
Professional
Modifier
RR · Rental
Typical Low
$758.58
Median
$758.58
Typical High
$758.58

Where Michigan sits

The same service costs 3.5 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Michigan· 11th of 51

$603

HI $1,122DE $316

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.