Static or dynamic ankle-foot orthosis, prefabricated at Dignity Health

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

ORTHO L4396 115X-150

Redding, CA

See all payers reporting HCPCS L4396 →

Payers reporting HCPCS L4396 at Dignity Health

Negotiated rates from the hospital’s own file: 6 payers, 18 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Anthem medicaid\|all plans fee schedule · inpatient	$116	$116	—	—	—	$116 – $116
2	Anthem medicaid\|all plans fee schedule · outpatient	$227	$227	—	—	—	$227 – $227
3	UnitedHealthcare commercial\|all other plans fee schedule · outpatient	$292	$292	—	—	—	$292 – $292
4	UnitedHealthcare commercial\|options fee schedule · outpatient	$292	$292	—	—	—	$292 – $292
5	UnitedHealthcare commercial\|hmo fee schedule · outpatient	$311	$311	—	—	—	$311 – $311
6	Blue Cross Blue Shield commercial\|exchange fee schedule · inpatient	$343	$343	—	—	—	$343 – $343
7	Anthem commercial\|exchange fee schedule · outpatient	$348	$348	—	—	—	$348 – $348
8	Cigna commercial\|all other plans fee schedule · inpatient	$371	$371	—	—	—	$371 – $371
9	Cigna commercial\|all other plans fee schedule · outpatient	$371	$371	—	—	—	$371 – $371
10	Cigna commercial\|ppo fee schedule · inpatient	$371	$371	—	—	—	$371 – $371
11	Cigna commercial\|ppo fee schedule · outpatient	$371	$371	—	—	—	$371 – $371
12	Blue Cross Blue Shield commercial\|all other plans fee schedule · inpatient	$399	$399	—	—	—	$399 – $399
13	Anthem commercial\|all other plans fee schedule · outpatient	$422	$422	—	—	—	$422 – $422
14	MultiPlan commercial\|all plans fee schedule · inpatient	$455	$455	—	—	—	$455 – $455
15	MultiPlan commercial\|all plans fee schedule · outpatient	$455	$455	—	—	—	$455 – $455
16	Aetna commercial\|all other plans fee schedule · inpatient	$464	$464	—	—	—	$464 – $464
17	Aetna commercial\|hmo fee schedule · inpatient	$464	$464	—	—	—	$464 – $464
18	Aetna commercial\|ppo fee schedule · inpatient	$464	$464	—	—	—	$464 – $464