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

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

Rates data updated July 2026.

Facilitymedian $158 · 10th–90th $100$2880%20%10th90th$158Professionalmedian $117 · 10th–90th $93$2450%20%40%10th90th$117$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
$27.54
Median
$112.20
Typical High
$162.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$120.23
Typical High
$257.04
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$186.21
Typical High
$269.15
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$691.83
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$120.23
Typical High
$190.55
BCBS
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$117.49
Typical High
$199.53
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$125.89
Medica
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$162.18
Typical High
$933.25
Medica
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$97.72
Typical High
$1,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$158.49
Typical High
$199.53
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$97.72
Typical High
$181.97