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

Mississippi 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$2450%20%40%10th90th$158Professionalmedian $120 · 10th–90th $91$1910%20%10th90th$120$50.0$100.0$200.0$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
$120.23
Median
$120.23
Typical High
$186.21
Aetna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$120.23
Typical High
$204.17
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$154.88
Typical High
$302.00
BCBS
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$158.49
BCBS
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$158.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$125.89
Typical High
$125.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$125.89
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$165.96
United
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$165.96
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$97.72
Typical High
$151.36