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

Nebraska 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.

Facilitymedian $200 · 10th–90th $98$9330%20%40%10th90th$200Professionalmedian $93 · 10th–90th $78$2040%20%40%10th90th$93$100.0$200.0$500.0$1.0K

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
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$123.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$93.33
Typical High
$162.18
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$151.36
Typical High
$489.78
BCBS
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$186.21
Typical High
$190.55
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$125.89
Typical High
$218.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$234.42
Typical High
$407.38
Medica
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$213.80
Typical High
$933.25
Medica
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$97.72
Typical High
$199.53
Midlands
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$524.81
Midlands
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$218.78
Midlands
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$489.78
Typical High
$524.81
United
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$199.53
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$97.72
Typical High
$162.18