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Ohio 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 $214 · 10th–90th $107$4790%20%10th90th$214Professionalmedian $110 · 10th–90th $85$1910%20%10th90th$110$0.2$1.0$5.0$20.0$100.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $154.88 / $478.63
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $107.15 / $181.97
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $158.49 / $223.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $218.78 / $436.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $120.23 / $269.15
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $173.78
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $245.47 / $316.23
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $275.42 / $457.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $125.89
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $125.89 / $125.89
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $138.04
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $109.65 / $158.49
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $229.09 / $416.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $165.96 / $245.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $97.72 / $151.36