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Idaho 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 $1,698 · 10th–90th $1,047–$2,0890%20%40%10th90th$1,698Professionalmedian $1,202 · 10th–90th $759–$2,0420%10%10th90th$1,202$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$758.58 / $1,071.52 / $1,584.89
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,698.24 / $2,454.71
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,041.74 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,096.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,047.13
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,621.81 / $2,137.96
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,659.59 / $1,819.70
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $1,288.25 / $1,584.89
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,737.80 / $1,737.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,905.46
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,819.70 / $1,819.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $954.99 / $1,071.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $831.76 / $1,318.26