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Alaska rates for HCPCS L4631

Ankle-foot orthosis (AFO), walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated

Facilitymedian $1,202 · 10th–90th $1,202–$2,2910%50%90th$1,202Professionalmedian $1,072 · 10th–90th $871–$2,2910%20%10th90th$1,072$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,023.29 / $1,584.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,047.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $2,754.23
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,584.89 / $2,290.87
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $2,290.87 / $5,495.41
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,290.87 / $2,398.83
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,290.87 / $2,398.83
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $2,238.72
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $1,047.13 / $1,698.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $1,071.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,698.24 / $5,888.44