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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 October 2026.

How much does Static or Dynamic Ankle-Foot Orthosis, Off-the-Shelf cost?

$97.72

Typical negotiated rate. In New Jersey, October 2026.

Insurers have agreed to pay about $97.72 for this service. The price depends on where it is billed: about $97.72 from a physician practice, and about $126 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$97.72$81.28 to $200
FacilityA hospital or hospital-owned outpatient department$126$117 to $126

How much rates vary

Facilitymedian $126 · 10th to 90th $69 to $200Professionalmedian $98 · 10th to 90th $69 to $200
$100$200facility $126professional $98

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$69.18
Median
$69.18
Typical High
$77.62
Aetna
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$69.18
Typical High
$112.20
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$34.67
Median
$34.67
Typical High
$42.66
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$14.13
Median
$14.13
Typical High
$16.98
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$10.47
Median
$10.47
Typical High
$12.88
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$7.08
Median
$7.08
Typical High
$8.51
AmeriHealth
Setting
Professional
Modifier
None
Typical Low
$131.83
Median
$131.83
Typical High
$208.93
Cigna
Setting
Facility
Modifier
None
Typical Low
$107.15
Median
$125.89
Typical High
$199.53
Cigna
Setting
Professional
Modifier
None
Typical Low
$93.33
Median
$93.33
Typical High
$125.89
Cigna
Setting
Professional
Modifier
RR · Rental
Typical Low
$10.72
Median
$10.72
Typical High
$10.72
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$131.83
Median
$263.03
Typical High
$263.03
Horizon BCBS
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Horizon BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$19.95
Median
$19.95
Typical High
$19.95
United
Setting
Facility
Modifier
None
Typical Low
$208.93
Median
$208.93
Typical High
$245.47
United
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$104.71
Typical High
$190.55

Where New Jersey sits

The same service costs 2.1 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Jersey· 50th of 51

$97.72

HI $200DE $93.33

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.