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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 October 2026.

How much does Static or Dynamic Ankle-Foot Orthosis, Off-the-Shelf cost?

$126

Typical negotiated rate. In Rhode Island, October 2026.

Insurers have agreed to pay about $126 for this service. The price depends on where it is billed: about $112 from a physician practice, and about $380 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$112$102 to $129
FacilityA hospital or hospital-owned outpatient department$380$302 to $437

How much rates vary

Facilitymedian $380 · 10th to 90th $245 to $479Professionalmedian $112 · 10th to 90th $85 to $170
$100$200$500facility $380professional $112

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$117.49
Median
$128.82
Typical High
$128.82
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$58.88
Median
$63.10
Typical High
$63.10
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$23.44
Median
$25.70
Typical High
$25.70
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$17.78
Median
$19.05
Typical High
$19.05
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$11.75
Median
$12.88
Typical High
$12.88
BCBS Rhode Island
Setting
Facility
Modifier
None
Typical Low
$302.00
Median
$407.38
Typical High
$478.63
BCBS Rhode Island
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$112.20
Typical High
$177.83
Cigna
Setting
Facility
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Cigna
Setting
Professional
Modifier
None
Typical Low
$93.33
Median
$93.33
Typical High
$125.89
United
Setting
Facility
Modifier
None
Typical Low
$245.47
Median
$245.47
Typical High
$245.47
United
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$128.82
Typical High
$169.82

Where Rhode Island sits

The same service costs 2.1 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Rhode Island· 30th of 51

$126

HI $200DE $93.33

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.