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

Georgia 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 $209 · 10th–90th $95$7590%20%10th90th$209Professionalmedian $141 · 10th–90th $95$2880%10%20%10th90th$141$0.2$1.0$5.0$20.0$100.0$500.0$2.0K

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
Facility
Modifier
Global
Typical Low
$95.50
Median
$95.50
Typical High
$251.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$125.89
Typical High
$288.40
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$288.40
Typical High
$398.11
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$489.78
Typical High
$758.58
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$169.82
Typical High
$263.03
CareSource
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$295.12
CareSource
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$263.03
Typical High
$323.59
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$125.89
Typical High
$125.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$245.47
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$208.93
Typical High
$371.54
United
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$89.13
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$102.33
Typical High
$204.17