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North Carolina 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 $178 · 10th–90th $89–$3550%20%10th90th$178Professionalmedian $129 · 10th–90th $87–$2140%20%10th90th$129$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
$177.83 / $177.83 / $177.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $125.89 / $245.47
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $151.36 / $213.80
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $165.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $134.90
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $177.83 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $91.20 / $165.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $100.00 / $154.88
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $954.99
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,479.11