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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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.95 / $113.95 / $181.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.40 / $129.97 / $183.39
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.51 / $152.51 / $200.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$159.13 / $159.13 / $159.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.13 / $159.13 / $159.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.02 / $127.07 / $127.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.76 / $92.76 / $127.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.97 / $98.27 / $159.13