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New Hampshire 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 $209 · 10th–90th $120–$2510%20%10th90th$209Professionalmedian $132 · 10th–90th $93–$1820%20%10th90th$132$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $120.23 / $169.82
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $158.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $223.87 / $257.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $120.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $125.89 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $125.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $331.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $89.13 / $104.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $138.04 / $181.97
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $223.87