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Minnesota 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 $2,089 · 10th–90th $1,514–$12,8820%20%10th90th$2,089Professionalmedian $1,778 · 10th–90th $912–$2,0420%50%10th90th$1,778$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
$1,230.27 / $1,230.27 / $1,230.27
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,000.00 / $1,230.27
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,778.28 / $2,290.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,778.28 / $1,778.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $6,606.93 / $15,848.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,344.23 / $2,630.27
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,370.32 / $6,606.93 / $12,882.50
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,041.74 / $2,818.38
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,778.28 / $8,912.51
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $831.76 / $1,949.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.18 / $812.83 / $2,691.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $977.24 / $2,511.89