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Static or Dynamic Ankle-Foot Orthosis, Off-the-Shelf

Arizona 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

Rates data updated July 2026.

Facilitymedian $178 · 10th–90th $60$3800%10%10th90th$178Professionalmedian $112 · 10th–90th $78$2450%20%10th90th$112$0.2$1.0$5.0$20.0$100.0$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
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$112.20
Typical High
$245.47
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$147.91
Typical High
$199.53
BCBS
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$218.78
Typical High
$416.87
BCBS
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$194.98
Typical High
$407.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$125.89
Medica
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$131.83
Typical High
$407.38
Medica
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$89.13
Typical High
$1,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$158.49
Typical High
$199.53
United
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$89.13
Typical High
$141.25