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

New Mexico 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 $933 · 10th–90th $100$2,5120%5%10%10th90th$933Professionalmedian $132 · 10th–90th $85$2040%10%20%10th90th$132$100.0$500.0$2.0K$10.0K$50.0K

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
$100.00
Median
$100.00
Typical High
$100.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$112.20
Typical High
$204.17
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
BCBS
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$1,584.89
Typical High
$2,691.53
BCBS
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$162.18
Typical High
$194.98
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$295.12
Molina
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$295.12
Typical High
$446.68
Providence
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$131.83
Typical High
$218.78
Providence
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$204.17
United
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$97.72
Typical High
$245.47
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$89.13
Typical High
$141.25