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Oklahoma 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.14 / $96.14 / $96.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.58 / $96.14 / $112.90
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.66 / $274.50 / $274.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$178.04 / $178.04 / $178.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.02 / $127.07 / $127.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.76 / $92.76 / $234.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.21 / $132.06 / $939.42
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.97 / $97.20 / $201.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.97 / $95.48 / $141.12