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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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.61 / $112.90 / $178.05
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.52 / $145.52 / $174.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.94 / $184.01 / $332.68
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.96 / $169.79 / $218.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.07 / $127.07 / $127.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.76 / $92.76 / $234.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.37 / $132.06 / $939.42
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.46 / $89.95 / $141.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $89.95 / $141.12