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New Mexico 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 $5,623 · 10th–90th $891–$14,7910%5%10%10th90th$5,623Professionalmedian $933 · 10th–90th $794–$1,5850%20%10th90th$933$100.0$500.0$2.0K$10.0K$50.0K

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
$851.14 / $891.25 / $1,348.96
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,890.45 / $9,549.93 / $15,488.17
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,445.44 / $1,698.24
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 / $2,187.76
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,778.28 / $2,691.53
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $1,230.27 / $2,238.72
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,862.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $891.25 / $2,238.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $831.76 / $1,258.93