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Missouri 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 $162 · 10th–90th $100–$3090%20%10th90th$162Professionalmedian $112 · 10th–90th $85–$2040%20%10th90th$112$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $112.20 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $107.15 / $234.42
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $691.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $120.23 / $190.55
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $199.53
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $125.89 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $162.18 / $933.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $97.72 / $1,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $158.49 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $95.50 / $177.83