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

Indiana 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 $204 · 10th–90th $100$2570%20%40%10th90th$204Professionalmedian $110 · 10th–90th $89$2040%20%40%10th90th$110$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
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$104.71
Typical High
$204.17
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$181.97
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$204.17
Typical High
$257.04
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$208.93
CareSource
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$263.03
Typical High
$302.00
CareSource
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$263.03
Typical High
$281.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$125.89
Typical High
$281.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$213.80
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$138.04
Typical High
$204.17
United
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$100.00
Typical High
$158.49