Custom plastic ankle-foot brace

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

AFO MOLDED TO PATIENT PLASTI

Payers reporting HCPCS L1940

Payer pricing summary

Low

$197

Average

$795

Median

$731

High

$2.1k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +24 other terms	389	$614	$682	$348	51%	—	$1 – $3.1k
2	Aetna fee schedule · outpatient · +25 other terms	365	$617	$727	$364	50%	—	$1 – $4.3k
3	Humana fee schedule · outpatient · +22 other terms	323	$608	$885	$926	105%	—	$1 – $4.5k
4	Blue Cross Blue Shield fee schedule · outpatient · +18 other terms	239	$627	$845	$465	55%	—	$0 – $3.1k
5	WellCare fee schedule · outpatient · +11 other terms	211	$614	$638	$148	23%	—	$244 – $1.4k
6	Devoted fee schedule · outpatient · +7 other terms	165	$614	$592	$26	4%	—	$546 – $773
7	Molina fee schedule · outpatient · +17 other terms	150	$805	$802	$302	38%	—	$1 – $1.5k
8	Cigna fee schedule · outpatient · +19 other terms	118	$633	$908	$585	64%	—	$364 – $2.7k
9	Cigna Healthspring fee schedule · outpatient · +4 other terms	116	$594	$601	$37	6%	—	$568 – $780
10	Anthem fee schedule · outpatient · +20 other terms	89	$585	$972	$776	80%	—	$322 – $4.5k
11	Kaiser fee schedule · outpatient · +13 other terms	73	$580	$982	$711	72%	—	$499 – $4.5k
12	Ambetter facility · fee schedule · outpatient · +11 other terms	47	$1.1k	$1.1k	$266	24%	—	$434 – $1.6k
13	Caresource fee schedule · outpatient · +11 other terms	45	$614	$580	$96	17%	—	$1 – $925
14	Superior Healthplan fee schedule · outpatient · +3 other terms	40	$611	$611	$3	0%	—	$570 – $611
15	Clover fee schedule · outpatient · +3 other terms	37	$707	$667	$44	7%	—	$611 – $758
16	Oscar fee schedule · outpatient · +7 other terms	36	$645	$724	$229	32%	—	$570 – $1.3k
17	Optum fee schedule · outpatient · +9 other terms	33	$614	$766	$305	40%	—	$546 – $1.5k
18	Baylor Scott White Health Plan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	26	$123	$233	$121	52%	—	$113 – $392
19	Medica facility · fee schedule · outpatient · +10 other terms	23	$611	$550	$125	23%	—	$199 – $812
20	Regence facility · fee schedule · outpatient · +7 other terms	19	$591	$583	$24	4%	—	$509 – $602
21	Amerihealth Caritas fee schedule · outpatient · +4 other terms	18	$737	$714	$49	7%	—	$580 – $737
22	Bcbs Tx fee schedule · outpatient · +2 other terms	18	$570	$570	—	—	—	$570 – $570
23	Medicare fee schedule · outpatient · +7 other terms	18	$546	$548	$4	1%	—	$546 – $557
24	Tricare facility · fee schedule · outpatient · +5 other terms	16	$568	$599	$60	10%	—	$557 – $721
25	Medical Mutual facility · fee schedule · outpatient · +4 other terms	15	$598	$692	$171	25%	—	$326 – $946

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