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

Vermont 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?

$107

Typical negotiated rate. In Vermont, October 2026.

Insurers have agreed to pay about $107 for this service. Most negotiated rates run $93.33 to $166.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $126 · 10th to 90th $107 to $141Professionalmedian $105 · 10th to 90th $93 to $170
$100$200$500$1Kfacility $126professional $105

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
$104.71
Median
$104.71
Typical High
$134.90
BCBS Vermont
Setting
Professional
Modifier
None
Typical Low
$165.96
Median
$165.96
Typical High
$165.96
Cigna
Setting
Facility
Modifier
None
Typical Low
$107.15
Median
$125.89
Typical High
$141.25
Cigna
Setting
Professional
Modifier
None
Typical Low
$93.33
Median
$93.33
Typical High
$107.15
Cigna
Setting
Professional
Modifier
RR · Rental
Typical Low
$10.72
Median
$10.72
Typical High
$10.72
MVP Health Care
Setting
Professional
Modifier
None
Typical Low
$162.18
Median
$162.18
Typical High
$199.53
United
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$162.18
Typical High
$416.87

Where Vermont 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.

Vermont· 47th of 51

$107

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.