Static or dynamic ankle-foot orthosis, prefabricated at Mayo Clinic

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

HC ORTHOSIS ANKLE/FOOT CUSTOM

Rochester, MN

See all hospitals reporting HCPCS L4396 →

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Pricing by billing methodology

Price type

How this price compares nationally

Mayo Clinic’s median price of $56 is 73% below the median hospital's median price ($208), higher than 2% of the 1,319 hospitals reporting HCPCS L4396. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L4396 at Mayo Clinic

Negotiated rates from the hospital’s own file: 18 payers, 61 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	Blue Cross Blue Shield medicaid base apr drg only [1276] facility · percent of total billed charges · bothfrom % of charges	$20	$20	$8	38%	—	$12 – $27
2	Blue Cross Blue Shield medicaid base apr drg only [1277] facility · percent of total billed charges · bothfrom % of charges	$20	$20	$8	38%	—	$12 – $27
3	Healthpartners medicaid cah healthpartners [1174] facility · percent of total billed charges · bothfrom % of charges	$20	$20	$8	38%	—	$12 – $27
4	Molina medicaid base apr drg only [1276] facility · percent of total billed charges · bothfrom % of charges	$20	$20	$8	38%	—	$12 – $27
5	Ucare medicaid base apr drg only [1276] facility · percent of total billed charges · bothfrom % of charges	$20	$20	$8	38%	—	$12 – $27
6	Ucare pps medicaid ucare [1184] facility · percent of total billed charges · bothfrom % of charges	$20	$20	$8	38%	—	$12 – $27
7	UnitedHealthcare medicaid base apr drg only [1276] facility · percent of total billed charges · bothfrom % of charges	$20	$20	$8	38%	—	$12 – $27
8	Medica medica medicaid [1244] facility · percent of total billed charges · bothfrom % of charges	$46	$46	$18	38%	—	$29 – $64
9	Medica medica medicare advantage plan msho msc+ cap [167] facility · percent of total billed charges · bothfrom % of charges	$48	$48	$18	38%	—	$30 – $66
10	Medica medicaid medica choice care msc+ [1175] facility · percent of total billed charges · bothfrom % of charges	$48	$48	$18	38%	—	$30 – $66
11	Aetna all other plans [9] facility · percent of total billed charges · bothfrom % of charges	$56	$56	—	—	—	$56 – $56
12	Anthem all other plans [9] facility · percent of total billed charges · bothfrom % of charges	$56	$56	—	—	—	$56 – $56
13	Blue Cross Blue Shield all other plans [9] facility · percent of total billed charges · bothfrom % of charges	$56	$56	—	—	—	$56 – $56
14	Humana all other plans [9] facility · percent of total billed charges · bothfrom % of charges	$56	$56	—	—	—	$56 – $56
15	Kaiser all other plans [9] facility · percent of total billed charges · bothfrom % of charges	$56	$56	—	—	—	$56 – $56
16	Medica all other plans [9] facility · percent of total billed charges · bothfrom % of charges	$56	$56	—	—	—	$56 – $56
17	Oscar all other plans [9] facility · percent of total billed charges · bothfrom % of charges	$56	$56	—	—	—	$56 – $56
18	Sanford Health Plan all other plans [9] facility · percent of total billed charges · bothfrom % of charges	$56	$56	—	—	—	$56 – $56
19	Optum medica ma medicare advantage plan behavioral health [1350] facility · percent of total billed charges · bothfrom % of charges	$58	$58	$22	38%	—	$36 – $80
20	Blue Cross Blue Shield blue cross blue shield aco [851] facility · percent of total billed charges · bothfrom % of charges	$84	$84	$32	38%	—	$52 – $115
21	Ucare ucare ifp [1108] facility · percent of total billed charges · bothfrom % of charges	$84	$84	$32	38%	—	$52 – $115
22	Blue Cross Blue Shield blue cross blue shield fep [874] facility · percent of total billed charges · bothfrom % of charges	$84	$84	$32	38%	—	$52 – $116
23	Anthem blue cross blue shield by payor [14] facility · percent of total billed charges · bothfrom % of charges	$86	$86	$32	38%	—	$53 – $118
24	Blue Cross Blue Shield blue cross blue shield by payor [14] facility · percent of total billed charges · bothfrom % of charges	$86	$86	$32	38%	—	$53 – $118
25	Blue Cross Blue Shield complex care complex and cancer care [806] facility · percent of total billed charges · bothfrom % of charges	$86	$86	$32	38%	—	$53 – $118

Page 1 of 3 · 61 rates

Last updated: Aug 14, 2026

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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.