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New Jersey 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 $69 · 10th–90th $69–$2000%50%90th$69Professionalmedian $107 · 10th–90th $78–$2000%10%10th90th$107$100.0$200.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $69.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $97.72 / $169.82
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $208.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $125.89 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $125.89
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $190.55 / $269.15
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $95.50 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $117.49 / $190.55