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

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

Rates data updated July 2026.

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

$178

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $178 for this service. The price depends on where it is billed: about $166 from a physician practice, and about $178 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 7 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$166$115 to $186
FacilityA hospital or hospital-owned outpatient department$178$129 to $209

How much rates vary

Facilitymedian $178 · 10th to 90th $89 to $339Professionalmedian $166 · 10th to 90th $95 to $257
$1.0$10.0$100.0$1.0Kfacility $178professional $166

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
Facility
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$177.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$177.83
Typical High
$263.03
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$154.88
Typical High
$208.93
BCBS
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$204.17
Typical High
$407.38
BCBS
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$165.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$134.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$134.90
Medcost
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$177.83
Typical High
$302.00
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$165.96
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$100.00
Typical High
$151.36
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$954.99
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,023.29
Typical High
$1,479.11

Where North Carolina sits

The same service costs 2.5 times more in Minnesota than in Washington, DC. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

North Carolina $178 · 6th of 51
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.