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Payers and negotiated rates for HCPCS L1901 | medprice.ai

HCPCS L1901

PR PREFAB ANKLE ORTHOSIS

Payer pricing summary

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Low

$5

Average

$124

Median

$23

High

$1.7k

Payer rate distribution

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Filter by billing methodology

Filter by billing class

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#
1	Blue Cross Blue Shield fee schedule · outpatient · +2 other terms	9	$71	$62	$17	28%	—	$18 – $87
2	First Health professional · percent of total billed charges · bothfrom % of charges	6	$20	$21	$2	10%	—	$20 – $26
3	Humana professional · percent of total billed charges · bothfrom % of charges	6	$20	$18	$6	31%	—	$11 – $23
4	MultiPlan professional · percent of total billed charges · bothfrom % of charges	5	$19	$17	$4	20%	—	$13 – $21
5	Caresource professional · percent of total billed charges · bothfrom % of charges	4	$10	$10	—	—	—	$10 – $10
6	Anthem facility · fee schedule · outpatient · +1 other terms	3	$13	$20	$9	46%	—	$13 – $32
7	Wellmark facility · per diem · inpatient	3	$1.8k	$1.7k	$934	55%	—	$928 – $3.0k
8	Aetna fee schedule · outpatient · +2 other terms	2	$35	$35	$0	1%	—	$34 – $35
9	Ambetter professional · percent of total billed charges · bothfrom % of charges	2	$17	$17	—	—	—	$17 – $17
10	Cigna fee schedule · outpatient · +2 other terms	2	$70	$70	$6	8%	—	$64 – $76
11	Excellus fee schedule · outpatient	2	$40	$41	$35	86%	—	$10 – $87
12	Kaiser fee schedule · both	2	$29	$29	—	—	—	$29 – $29
13	Molina fee schedule · outpatient · +1 other terms	2	$57	$57	$30	53%	—	$26 – $87
14	Phcs professional · percent of total billed charges · bothfrom % of charges	2	$20	$20	—	—	—	$20 – $20
15	UnitedHealthcare fee schedule · outpatient · +3 other terms	2	$74	$68	$33	49%	—	$10 – $87
16	Healthcare Highways percent of total billed charges · outpatientfrom % of charges	1	$25	$25	—	—	—	$25 – $25
17	Superior Healthplan percent of total billed charges · outpatientfrom % of charges	1	$5	$5	—	—	—	$5 – $5

← Hospitals reporting HCPCS L1901 · Snapshot 20261113T090226Z-3ce6c0b8