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

Idaho 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 $186 · 10th–90th $126$2140%50%10th90th$186Professionalmedian $132 · 10th–90th $81$2190%20%10th90th$132$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
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$120.23
Typical High
$213.80
BCBS
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$186.21
Typical High
$281.84
BCBS
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$218.78
Typical High
$218.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$134.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$125.89
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$186.21
Typical High
$208.93
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$186.21
Typical High
$199.53
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$141.25
Typical High
$169.82
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$190.55
Typical High
$190.55
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$218.78
Select Health
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$512.86
Select Health
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$186.21
Typical High
$218.78
United
Setting
Facility
Modifier
Global
Typical Low
$0.14
Median
$97.72
Typical High
$112.20
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$89.13
Typical High
$141.25