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California 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 $166 · 10th–90th $129$5500%20%10th90th$166Professionalmedian $123 · 10th–90th $93$3470%20%10th90th$123$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $851.14
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $123.03 / $316.23
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $138.04 / $147.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $165.96 / $501.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $120.23 / $316.23
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $295.12 / $457.09
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $363.08 / $724.44
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 / $125.89
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $151.36 / $239.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $177.83 / $323.59
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $954.99
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,479.11 / $1,479.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $199.53 / $263.03
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $190.55
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $158.49 / $204.17
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.79 / $89.13 / $245.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $100.00 / $239.88