go back

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

Rhode Island 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 $372 · 10th–90th $112$4790%10%20%10th90th$372Professionalmedian $112 · 10th–90th $89$2040%20%10th90th$112$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$114.82
Typical High
$204.17
BCBS
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$407.38
Typical High
$478.63
BCBS
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$112.20
Typical High
$181.97
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
United
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$112.20
Typical High
$245.47
United
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$128.82
Typical High
$169.82