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

Oregon 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 $191 · 10th–90th $148$2000%50%10th90th$191Professionalmedian $132 · 10th–90th $91$2400%20%10th90th$132$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
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$117.49
Typical High
$245.47
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
$93.33
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$398.11
Typical High
$478.63
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$147.91
Typical High
$199.53
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$177.83
Typical High
$218.78
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$194.98
Typical High
$194.98
Providence
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$165.96
Typical High
$218.78
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$169.82
Typical High
$204.17
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$199.53
Typical High
$758.58
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$218.78
Typical High
$218.78
United
Setting
Facility
Modifier
Global
Typical Low
$0.14
Median
$89.13
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$89.13
Typical High
$169.82