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Alaska rates for HCPCS L4397

Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf

Facilitymedian $132 · 10th–90th $132–$2000%50%90th$132Professionalmedian $129 · 10th–90th $98–$2820%20%10th90th$129$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $125.89 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $213.80
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $134.90 / $199.53
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $186.21 / $630.96
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $190.55 / $199.53
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $190.55 / $199.53
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $208.93
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $125.89 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $95.50
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $151.36 / $436.52