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North Dakota 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
$146.05 / $146.05 / $146.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.90 / $112.90 / $146.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.68 / $221.90 / $227.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.38 / $236.72 / $297.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.02 / $155.22 / $939.42
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.97 / $103.43 / $162.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.97 / $100.15 / $202.19