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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

Facilitymedian $851 · 10th–90th $100–$2,5120%5%10%10th90th$851Professionalmedian $112 · 10th–90th $89–$1820%10%20%10th90th$112$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $102.33 / $154.88
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $1,584.89 / $2,570.40
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $162.18 / $194.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $251.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $295.12 / $446.68
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $131.83 / $218.78
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $204.17
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $97.72 / $245.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $89.13 / $141.25