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Tennessee 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 $1,259 · 10th–90th $813–$9,1200%20%10th90th$1,259Professionalmedian $891 · 10th–90th $794–$1,5850%50%10th90th$891$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
$812.83 / $891.25 / $1,412.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $891.25 / $1,513.56
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $1,819.70
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,445.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,202.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,047.13
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,120.11 / $9,120.11 / $9,120.11
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,715.19 / $15,848.93 / $15,848.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $831.76 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $870.96 / $1,258.93