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

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

Rates data updated July 2026.

Facilitymedian $69 · 10th–90th $69$2000%50%90th$69Professionalmedian $112 · 10th–90th $78$2000%10%20%10th90th$112$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$95.50
Typical High
$204.17
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$131.83
Typical High
$331.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$125.89
Typical High
$199.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$125.89
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$186.21
Typical High
$263.03
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
United
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$199.53
Typical High
$199.53
United
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$120.23
Typical High
$190.55