go back

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

Hawaii 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.

How much does Static or Dynamic Ankle-Foot Orthosis, Off-the-Shelf cost?

$200

Typical negotiated rate. In Hawaii, July 2026.

Insurers have agreed to pay about $200 for this service. Most negotiated rates run $112 to $204.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $107 · 10th to 90th $89 to $155Professionalmedian $200 · 10th to 90th $105 to $209
$100$200facility $107professional $200

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$112.20
Typical High
$204.17
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$125.89
Typical High
$154.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$181.97
Typical High
$245.47
HMSA
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$208.93
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$199.53
Typical High
$275.42
United
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$91.20
Typical High
$112.20
United
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$151.36
Typical High
$239.88

Where Hawaii sits

The same service costs 2.5 times more in Minnesota than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Hawaii· 2nd of 51

$200

MN $204DC $81.28

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.