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

Nevada 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 $66 · 10th–90th $66$2000%50%90th$66Professionalmedian $105 · 10th–90th $76$2450%10%10th90th$105$2.0$10.0$50.0$200.0

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
$66.07
Median
$66.07
Typical High
$66.07
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$85.11
Typical High
$245.47
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$147.91
Typical High
$186.21
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$208.93
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$120.23
Typical High
$120.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$125.89
Typical High
$154.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$125.89
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$199.53
Typical High
$338.84
Select Health
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Select Health
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$177.83
Typical High
$199.53
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$89.13
Typical High
$112.20
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$141.25
Typical High
$218.78