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Texas 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 $166 · 10th–90th $89$5750%10%20%10th90th$166Professionalmedian $98 · 10th–90th $89$1700%50%10th90th$98$0.2$1.0$5.0$20.0$100.0$500.0$2.0K

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
$89.13 / $89.13 / $93.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $100.00 / $181.97
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $147.91 / $208.93
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,388.44 / $4,168.69
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $97.72
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $165.96 / $204.17
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $125.89
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $954.99
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,479.11 / $1,479.11
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $194.98 / $288.40
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $107.15 / $199.53
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $181.97 / $288.40
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $141.25 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $112.20 / $141.25
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $208.93 / $208.93