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

Kentucky 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 $141 · 10th–90th $91$2820%20%10th90th$141Professionalmedian $115 · 10th–90th $95$2240%20%40%10th90th$115$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
$104.71
Median
$104.71
Typical High
$107.15
Aetna
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$109.65
Typical High
$245.47
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$154.88
Typical High
$165.96
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$208.93
Typical High
$218.78
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$158.49
Typical High
$158.49
CareSource
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$275.42
Typical High
$354.81
CareSource
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$257.04
Typical High
$323.59
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$281.84
Typical High
$281.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$165.96
Typical High
$977.24
Molina
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$165.96
Typical High
$213.80
United
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$89.13
Typical High
$112.20
United
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$100.00
Typical High
$173.78