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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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$98.78 / $104.51 / $108.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.03 / $108.59 / $136.02
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.52 / $152.51 / $152.51
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$126.58 / $203.34 / $213.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.95 / $159.13 / $159.13
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$197.31 / $223.67 / $323.50
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.19 / $252.74 / $325.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.02 / $127.07 / $238.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.76 / $127.07 / $967.52
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.49 / $159.13 / $198.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.63 / $100.54 / $162.66