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

Maine 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?

$123

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $123 for this service. The price depends on where it is billed: about $123 from a physician practice, and about $240 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$123$112 to $182
FacilityA hospital or hospital-owned outpatient department$240$126 to $245

How much rates vary

Facilitymedian $240 · 10th to 90th $112 to $282Professionalmedian $123 · 10th to 90th $93 to $182
$100$200$500facility $240professional $123

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
$89.13
Median
$112.20
Typical High
$125.89
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$245.47
Typical High
$281.84
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$125.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$125.89
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$213.80
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$120.23
Typical High
$131.83
United
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$89.13
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$177.83
Typical High
$181.97

Where Maine 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.

Maine· 21st of 51

$123

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.