Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Afo molded ankle gauntlet
Low
$1
Average
$726
Median
$635
High
$5.1k
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Prices here combine facility and professional fees. See them separately →Experimental
Showing prices across every billing methodology. Pick one in the filter above to narrow the chart. 825 hospitals; the 90th percentile is 1.9× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | St. Anthony Shawnee Hospital, Inc Shawnee, OK | $711 | $718 | $179 | 25% | — | $540 – $1.1k |
| 2 | Lewisgale Hospital Montgomery CHRISTIANSBURG, VA | $644 | $645 | $34 | 5% | — | $548 – $689 |
| 3 | Ingalls Memorial Hospital Harvey, IL | $582 | $582 | $28 | 5% | — | $555 – $610 |
| 4 | Fairview Health Services Edina, MN | $608 | $992 | $853 | 86% | — | $245 – $4.7k |
| 5 | Hca Florida West Hospital PENSACOLA, FL | $567 | $657 | $232 | 35% | — | $524 – $1.3k |
| 6 | Mayo Regional Hospital Dover Foxcroft, ME | $322 | $395 | $253 | 64% | — | $32 – $876 |
| 7 | Corewell Health Ludington Hospital Ludington, MI | $582 | $712 | $203 | 29% | — | $555 – $999 |
| 8 | Kettering Medical Center Miamisburg, OH | $861 | $952 | $313 | 33% | — | $555 – $1.5k |
| 9 | Hoopeston Community Memorial Hospital Hoopeston, IL | $293 | $380 | $123 | 32% | — | $293 – $555 |
| 10 | Deaconess Hospital, Inc Newburgh, IN | $531 | $531 | — | — | — | $531 – $531 |
Ask Claude or any MCP client for HCPCS L1904 pricing at a specific hospital — see how to connect.