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Wyoming 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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.41 / $112.41 / $175.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$196.03 / $196.03 / $196.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.03 / $196.03 / $196.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.07 / $127.07 / $213.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.76 / $92.76 / $179.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.67 / $89.95 / $99.86