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

Montana 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.

How much does Static or Dynamic Ankle-Foot Orthosis, Off-the-Shelf cost?

$145

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $145 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $195 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$126$112 to $195
FacilityA hospital or hospital-owned outpatient department$195$195 to $234

How much rates vary

Facilitymedian $195 · 10th to 90th $155 to $288Professionalmedian $126 · 10th to 90th $78 to $380
$100$200$500facility $195professional $126

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$112.20
Typical High
$707.95
BCBS
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$208.93
Typical High
$208.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$208.93
Typical High
$208.93
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$194.98
Typical High
$380.19
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$194.98
Typical High
$380.19
Providence
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$199.53
Typical High
$239.88
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$158.49
Typical High
$208.93
United
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$95.50
Typical High
$112.20
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$89.13
Typical High
$141.25

Where Montana sits

The same service costs 2.5 times more in Minnesota than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Montana· 13th of 51

$145

MN $204DC $81.28

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.