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Tibial Fracture Orthosis, Semi-Rigid, Prefabricated

South Carolina 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?

$380

Typical negotiated rate. In South Carolina, October 2026.

Insurers have agreed to pay about $380 for this service. The price depends on where it is billed: about $380 from a physician practice, and about $407 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$380$347 to $661
FacilityA hospital or hospital-owned outpatient department$407$355 to $661

How much rates vary

Facilitymedian $407 · 10th to 90th $324 to $661Professionalmedian $380 · 10th to 90th $295 to $661
$200$500$1Kfacility $407professional $380

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$323.59
Median
$323.59
Typical High
$323.59
Aetna
Setting
Professional
Modifier
None (both parts)
Typical Low
$323.59
Median
$323.59
Typical High
$407.38
BCBS South Carolina
Setting
Facility
Modifier
None
Typical Low
$602.56
Median
$660.69
Typical High
$660.69
BCBS South Carolina
Setting
Professional
Modifier
None (both parts)
Typical Low
$380.19
Median
$562.34
Typical High
$660.69
Cigna
Setting
Facility
Modifier
None
Typical Low
$407.38
Median
$407.38
Typical High
$407.38
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$295.12
Median
$295.12
Typical High
$407.38
Medcost
Setting
Professional
Modifier
None
Typical Low
$371.54
Median
$371.54
Typical High
$467.74
Medcost
Setting
Facility
Modifier
None
Typical Low
$208.93
Median
$389.05
Typical High
$812.83
Medcost
Setting
Professional
Modifier
None (both parts)
Typical Low
$371.54
Median
$467.74
Typical High
$870.96
Molina
Setting
Professional
Modifier
None (both parts)
Typical Low
$446.68
Median
$446.68
Typical High
$446.68
United
Setting
Facility
Modifier
None
Typical Low
$436.52
Median
$891.25
Typical High
$891.25
United
Setting
Professional
Modifier
None (both parts)
Typical Low
$251.19
Median
$323.59
Typical High
$407.38
12 more rates 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
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$162.18
Median
$162.18
Typical High
$199.53
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$64.57
Median
$64.57
Typical High
$81.28
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$48.98
Median
$48.98
Typical High
$60.26
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$32.36
Median
$32.36
Typical High
$40.74
Medcost
Setting
Professional
Modifier
26 · Professional part
Typical Low
$186.21
Median
$194.98
Typical High
$467.74
Medcost
Setting
Professional
Modifier
50 · Both sides
Typical Low
$549.54
Median
$707.95
Typical High
$1,737.80
Medcost
Setting
Professional
Modifier
51 · Multiple procedures
Typical Low
$181.97
Median
$234.42
Typical High
$575.44
Medcost
Setting
Professional
Modifier
80 · Assistant surgeon
Typical Low
$74.13
Median
$93.33
Typical High
$229.09
Medcost
Setting
Professional
Modifier
81 · Minimal assistant surgeon
Typical Low
$51.29
Median
$66.07
Typical High
$162.18
Medcost
Setting
Professional
Modifier
82 · Assistant surgeon, no resident
Typical Low
$51.29
Median
$66.07
Typical High
$162.18
Medcost
Setting
Professional
Modifier
AS · PA/NP assist
Typical Low
$51.29
Median
$66.07
Typical High
$162.18
Medcost
Setting
Professional
Modifier
TC · Technical part
Typical Low
$281.84
Median
$295.12
Typical High
$691.83

Where South Carolina 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.

South Carolina· 41st of 51

$380

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.