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
What Washington hospitals publish for this code
Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.
| Hospital | Medicare Advantage rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $194 – $213 | $101 – $149 | $252 – $373 |
| Deaconess Medical Center | $194 – $213 | $101 – $149 | $252 – $373 |
| Harborview Medical Center | $198 – $218 | $239 – $242 | $342 – $346 |
| Kadlec Regional Medical Center | $198 – $237 | $108 – $159 | $154 – $227 |
| Legacy Salmon Creek Medical Center | — | $13.00 | $20.00 |
| Mary Bridge Children's Hospital | $194 – $213 | $101 – $149 | $252 – $373 |
| MultiCare Auburn Medical Center | $194 – $213 | $101 – $149 | $252 – $373 |
| MultiCare Covington Medical Center | $194 – $213 | $101 – $149 | $252 – $373 |
| MultiCare Good Samaritan Hospital | $194 – $213 | $101 – $149 | $252 – $373 |
| MultiCare Valley Hospital | $200 – $213 | $101 – $149 | $252 – $373 |
| Overlake Hospital Medical Center & Clinics | $198 – $206 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $198 – $237 | $223 – $341 | $319 – $487 |
| Providence Centralia Hospital | $198 – $317 | $137 – $201 | $263 – $386 |
| Providence Holy Family Hospital | — | $232 – $341 | $331 – $487 |
| Providence Mount Carmel Hospital | — | $218 – $321 | $312 – $458 |
| Providence Regional Medical Center Everett | $198 – $218 | $145 – $213 | $279 – $410 |
| Providence St Joseph Hospital | — | $218 – $321 | $312 – $458 |
| Providence St Mary Medical Center | — | $138 – $203 | $197 – $290 |
| Providence St Peter Hospital | $198 – $317 | $137 – $201 | $263 – $386 |
| Seattle Children's Hospital | — | $366 | $366 |
| Swedish Edmonds Hospital | $198 – $237 | $89.82 – $132 | $187 – $275 |
| Swedish Issaquah | $198 – $237 | $89.82 – $300 | $187 – $624 |
| Swedish Medical Center | $198 – $237 | $89.82 – $300 | $187 – $624 |
| Swedish Medical Center / Cherry Hill | $198 – $237 | $89.82 – $300 | $187 – $624 |
| Tacoma General Allenmore Hospital | $194 – $213 | $101 – $149 | $252 – $373 |
| University of Washington Medical Ctr | $198 – $218 | $310 – $318 | $443 – $455 |
| Virginia Mason Medical Center | $136 – $204 | — | — |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $194 – $217 | $78.80 – $101 | $197 – $252 |
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)