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Maryland 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 $955 · 10th–90th $562–$1,2590%10%20%10th90th$955Professionalmedian $933 · 10th–90th $759–$1,5850%20%10th90th$933$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $933.25 / $1,584.89
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,318.26
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,905.46 / $2,884.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $812.83 / $1,288.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $954.99 / $1,513.56
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,621.81