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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

Facilitymedian $209 · 10th–90th $95–$7590%10%20%10th90th$209Professionalmedian $135 · 10th–90th $93–$2750%10%20%10th90th$135$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $251.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $120.23 / $275.42
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $295.12 / $380.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $489.78 / $758.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $169.82 / $263.03
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $281.84 / $323.59
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $251.19 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $125.89 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $245.47
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $208.93 / $371.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $89.13 / $165.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $102.33 / $199.53