Custom double-upright ankle-foot brace with calf band

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

HB-Ankle-Foot Orthosis, Double Bar

Payers reporting HCPCS L1990

Payer pricing summary

Low

$177

Average

$833

Median

$702

High

$6.6k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +21 other terms	378	$547	$590	$255	43%	—	$1 – $2.3k
2	Aetna fee schedule · outpatient · +21 other terms	362	$554	$670	$384	57%	—	$270 – $4.7k
3	Humana fee schedule · outpatient · +18 other terms	320	$542	$797	$820	103%	—	$291 – $3.9k
4	Blue Cross Blue Shield fee schedule · outpatient · +17 other terms	235	$553	$761	$422	55%	—	$0 – $2.5k
5	WellCare fee schedule · outpatient · +12 other terms	211	$543	$566	$123	22%	—	$209 – $1.2k
6	Devoted fee schedule · outpatient · +5 other terms	165	$542	$524	$24	5%	—	$492 – $696
7	Molina fee schedule · outpatient · +12 other terms	144	$754	$733	$278	38%	—	$298 – $1.3k
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$533	$531	$33	6%	—	$512 – $703
9	Cigna fee schedule · outpatient · +19 other terms	111	$558	$690	$312	45%	—	$341 – $2.4k
10	Anthem fee schedule · outpatient · +16 other terms	86	$520	$665	$692	104%	—	$31 – $4.3k
11	Kaiser fee schedule · outpatient · +11 other terms	69	$522	$987	$765	78%	—	$394 – $4.8k
12	Ambetter facility · fee schedule · outpatient · +8 other terms	47	$970	$1.0k	$228	23%	—	$417 – $1.4k
13	Caresource fee schedule · outpatient · +6 other terms	43	$542	$569	$112	20%	—	$291 – $888
14	Superior Healthplan fee schedule · outpatient · +1 other terms	40	$538	$538	$3	0%	—	$502 – $538
15	Clover fee schedule · outpatient · +3 other terms	37	$599	$577	$31	5%	—	$538 – $683
16	Oscar fee schedule · outpatient · +8 other terms	36	$569	$647	$212	33%	—	$502 – $1.2k
17	Optum fee schedule · outpatient · +7 other terms	33	$542	$684	$263	38%	—	$492 – $1.3k
18	Carefirst facility · percent of total billed charges · bothfrom % of charges	25	$600	$803	$511	64%	—	$292 – $2.3k
19	Medica facility · fee schedule · outpatient · +10 other terms	22	$587	$535	$143	27%	—	$191 – $985
20	Regence facility · fee schedule · outpatient · +7 other terms	20	$538	$565	$48	9%	—	$512 – $654
21	Amerihealth Caritas fee schedule · outpatient · +4 other terms	18	$650	$631	$40	6%	—	$522 – $650
22	Bcbs Tx fee schedule · outpatient	18	$502	$502	—	—	—	$502 – $502
23	Medicare fee schedule · outpatient · +1 other terms	18	$492	$494	$4	1%	—	$492 – $502
24	Tricare facility · fee schedule · outpatient · +3 other terms	16	$512	$532	$40	7%	—	$502 – $611
25	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$574	$662	$164	25%	—	$313 – $907

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