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Michigan 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

Facilitymedian $269 · 10th–90th $115$7410%20%10th90th$269Professionalmedian $115 · 10th–90th $85$2140%20%40%10th90th$115$0.2$1.0$5.0$20.0$100.0$500.0$2.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $269.15 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $112.20 / $213.80
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $151.36 / $154.88
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $602.56 / $1,174.90
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $213.80
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $245.47 / $436.52
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $281.84 / $288.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $125.89 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $125.89 / $223.87
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $186.21 / $269.15
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $114.82 / $245.47
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $125.89 / $125.89
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $134.90 / $199.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $165.96 / $245.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $95.50 / $158.49