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Indiana 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 $1,820 · 10th–90th $871–$2,2390%20%40%10th90th$1,820Professionalmedian $933 · 10th–90th $813–$1,5850%50%10th90th$933$2.0$10.0$50.0$200.0$1.0K$5.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $870.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $912.01 / $1,412.54
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $1,348.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,819.70 / $2,238.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,122.02 / $1,949.84
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,344.23 / $2,691.53
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,905.46
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $1,071.52 / $1,445.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $891.25 / $1,318.26