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.
Original text from hospital filings
Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molde
BRADENTON, FL
See all hospitals reporting HCPCS L4396 →Price type
Hca Florida Blake Hospital’s median price of $222 is 7% above the median hospital's median price ($208), higher than 67% of the 1,319 hospitals reporting HCPCS L4396. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 20 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 | Aetna qhp percent of total billed charges · outpatientfrom % of charges | $176 | $176 | — | — | — | $176 – $176 |
| 2 | UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges | $195 | $195 | — | — | — | $195 – $195 |
| 3 | Humana tricare fee schedule · outpatient | $201 | $201 | — | — | — | $201 – $201 |
| 4 | Aetna mcr fee schedule · outpatient | $207 | $207 | — | — | — | $207 – $207 |
| 5 | Caresource tricare fee schedule · outpatient | $207 | $207 | — | — | — | $207 – $207 |
| 6 | Devoted mcr fee schedule · outpatient | $207 | $207 | — | — | — | $207 – $207 |
| 7 | UnitedHealthcare mgmcd fee schedule · outpatient | $207 | $207 | — | — | — | $207 – $207 |
| 8 | Blue Cross Blue Shield mcrppo fee schedule · outpatient | $212 | $212 | — | — | — | $212 – $212 |
| 9 | Blue Cross Blue Shield mgmcrhmo fee schedule · outpatient | $212 | $212 | — | — | — | $212 – $212 |
| 10 | UnitedHealthcare mcr fee schedule · outpatient | $212 | $212 | — | — | — | $212 – $212 |
| 11 | Humana mgmcrppo fee schedule · outpatient | $218 | $218 | — | — | — | $218 – $218 |
| 12 | WellCare mcr fee schedule · outpatient | $218 | $218 | — | — | — | $218 – $218 |
| 13 | Cigna Healthspring mcr fee schedule · outpatient | $222 | $222 | — | — | — | $222 – $222 |
| 14 | Humana mgmcrhmo fee schedule · outpatient | $228 | $228 | — | — | — | $228 – $228 |
| 15 | Aetna gatedcomm percent of total billed charges · outpatientfrom % of charges | $269 | $269 | — | — | — | $269 – $269 |
| 16 | Aetna nongatedcomm percent of total billed charges · outpatientfrom % of charges | $269 | $269 | — | — | — | $269 – $269 |
| 17 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $358 | $358 | — | — | — | $358 – $358 |
| 18 | UnitedHealthcare globalbenefitplanappendix percent of total billed charges · outpatientfrom % of charges | $536 | $536 | — | — | — | $536 – $536 |
| 19 | MultiPlan primaryppo percent of total billed charges · outpatientfrom % of charges | $894 | $894 | — | — | — | $894 – $894 |
| 20 | MultiPlan complementaryppo percent of total billed charges · outpatientfrom % of charges | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
Last updated: Mar 1, 2026
See Static or dynamic ankle-foot orthosis, prefabricated pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.