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Washington, DC rates for HCPCS L4396

Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.76 / $102.99 / $102.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.76 / $80.76 / $108.29
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.16 / $110.16 / $134.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.25 / $82.25 / $82.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.25 / $128.25 / $391.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.63 / $98.44 / $147.91