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HCPCS L4396

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, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Current codeBelow Knee Orthotic29 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$171 – $1,32319 plans$101 – $149$252 – $373
Deaconess Medical CenterSpokaneFile dated 2026-08-27$93.62 – $82416 plans$101 – $149$252 – $373
Harborview Medical CenterSeattleFile dated 2026-04-01$317 – $3962 plans$239 – $242$342 – $346
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01$298 – $5565 plans$108 – $159$154 – $227
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01—$13.00$20.00
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$163 – $1,45218 plans$101 – $149$252 – $373
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$166 – $85520 plans$101 – $149$252 – $373
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$166 – $85520 plans$101 – $149$252 – $373
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$166 – $85520 plans$101 – $149$252 – $373
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$93.62 – $82216 plans$101 – $149$252 – $373
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$182 – $54410 plans——
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$307 – $6579 plans$223 – $341$319 – $487
Providence Centralia HospitalCentraliaFile dated 2026-04-01$334 – $7405 plans$137 – $201$263 – $386
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$232 – $341$331 – $487
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$218 – $321$312 – $458
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$237 – $4597 plans$145 – $213$279 – $410
Providence St Joseph HospitalChewelahFile dated 2026-04-01—$218 – $321$312 – $458
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01—$138 – $203$197 – $290
Providence St Peter HospitalOlympiaFile dated 2026-04-01$168 – $6468 plans$137 – $201$263 – $386
Seattle Children's HospitalSeattle$197 – $35198 plans$366$366
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$297 – $7267 plans$89.82 – $132$187 – $275
Swedish IssaquahIssaquahFile dated 2026-04-01$297 – $4397 plans$89.82 – $300$187 – $624
Swedish Medical CenterSeattleFile dated 2026-04-01$297 – $7079 plans$89.82 – $300$187 – $624
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$297 – $7079 plans$89.82 – $300$187 – $624
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$166 – $85520 plans$101 – $149$252 – $373
University of Washington Medical CtrSeattleFile dated 2026-04-01$317 – $6215 plans$310 – $318$443 – $455
Virginia Mason Medical CenterSeattle$189 – $6887 plans——
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27$4991 plan——
Yakima Valley MemorialYakimaFile dated 2026-08-27$96.53 – $51319 plans$78.80 – $101$197 – $252

Lowest and highest amounts each hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Equipment fee, Washington
$198 (fee)