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Tibial Fracture Orthosis (AFO), Rigid, Prefabricated

Pennsylvania rates for HCPCS L2116

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

Rates data updated July 2026.

How much does Tibial Fracture Orthosis (AFO), Rigid, Prefabricated cost?

$437

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $437 for this service. The price depends on where it is billed: about $437 from a physician practice, and about $933 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 9 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$437$363 to $537
FacilityA hospital or hospital-owned outpatient department$933$363 to $1,413

How much rates vary

Facilitymedian $933 · 10th to 90th $363 to $3,311Professionalmedian $437 · 10th to 90th $363 to $708
$1.0$10.0$100.0$1.0K$10.0Kfacility $933professional $437

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$1,412.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$426.58
Typical High
$602.56
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$724.44
Typical High
$912.01
Cigna
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$501.19
Typical High
$1,258.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$501.19
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,288.25
Typical High
$1,862.09
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$912.01
Typical High
$912.01
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$630.96
Typical High
$912.01
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$1,412.54
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$426.58
Typical High
$707.95
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$588.84
Typical High
$588.84
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$851.14
Median
$2,951.21
Typical High
$4,786.30
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$851.14
Typical High
$912.01
United
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$1,096.48
Typical High
$1,096.48
United
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$446.68
Typical High
$954.99

Where Pennsylvania sits

The same service costs 3.9 times more in Hawaii than in Washington, DC. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Pennsylvania $437 · 43rd of 51
HI $1,413DC $363

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.