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

West Virginia 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 $102 · 10th–90th $102$2750%50%90th$102Professionalmedian $100 · 10th–90th $81$1380%20%10th90th$100$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
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$97.72
Typical High
$112.20
CareSource
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$275.42
Typical High
$281.84
CareSource
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$245.47
Typical High
$338.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$281.84
Typical High
$281.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$977.24
United
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$89.13
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$120.23
Typical High
$186.21