What Is An Accurate Price For an AFO?
Our goal here is to give you that answer. But if we told you that there was only one price, we would be lying to you. Our goal, with this blog post is to clear up this question and get you some good information. It is not extremely complicated, but if we don’t go through each example you might not feel like you got the answer you came here for.
If you want the short answer, the cost of an AFO can range from : $59.99 to $1053.00 if you get it on an outpatient basis. Inpatient is different and no orthotist can give you that price.
In our best efforts to be as transparent as possible, we have to explain the price of an ankle foot orthosis (AFO) in a way that is just more than stating prices.
Because there are different kinds of AFOs. There are different kinds of walking problems, thus the need for more choices.
Moreover, some of these walking aids are off the shelf. While others are custom made. So the best anyone can do for you is get you close on cost. The prefabricated and custom made ones have variations too.
Therefore, you will have to pick out the one you are thinking of below and it can help you to come to a price based off of your situation and preferences.
If you are not sure which one you need, that is fine. That is normal actually.
We suggest that consult an orthotist if you have questions though. They can evaluate you in person and really help you find the one you need if you are unsure.
You can look at the above paragraph alone and quickly see why we have to go into an in depth explanation so you get the answer to the question you are thinking about.
The Cost of Off The Shelf AFOs / Prefabricated Ankle Foot Orthoses (AFOs)
There are two categories for off the shelf walking aids like this :
A.) Prefabricated Plastic
B.) Carbon Graphite
Prefabricated Plastic AFOs
The plastic in these braces is actually referred to as thermoplastic. This is helpful in case you go elsewhere and hear the term.
Thermoplastic AFOs are typically heat moldable to a patient model, for example. This means to a cast model of what is considered a “normal” shape.
You can go online and find them at an inexpensive rate. However, this can be a good thing and this can be a bad thing.
You can basically see the ones we showed you here online for :
$59.99, before tax and shipping. (Tax varies, but shipping should be an extra $12-20 dollars depending on the distance etc.)
If this brace works for you then great! But my experience is that the shape of the foot can become problematic. You can’t wish this problem away. The shape of this walking aid is not like a shoe. Meaning, it is rigid, unlike a shoe or a sock, for example. We bring this up because shoes and socks are typically prefabricate items that work out fine, but this is because they can bend and stretch.
An AFO like this is different, so the fit better basically be perfect or you are going to be looking elsewhere again for the same product. If you purchase them online, you will have to figure out the proper size and deal with problems that arise on your own, to be frank.
These AFOs can provide value for the right person, but if you need a section heated up and relieved, then you have two choices. Do it yourself or send the brace back and hope they take returns after it has touched your skin. Some places don’t. Some do. So you will just have to ask around. (Hopefully you will not see an image like the one here at the right.)
Therefore, the upside here is that the cost is lower. The downside is you are stuck with problems like the midfoot width is digging into your navicular bone or the heel circumference is causing a blister because it was not made to your foot shape, but rather someone that was deemed “average” when it was made.
The Price For This Plastic Prefab Brace If You Go To An Orthotist In Town
If you were going to see an orthotist (a brace specialist), they typically will not charge you this price stated above. It would be more. The reason why is that they have to base their numbers off of a hcpc code if it is going to be billed to your insurance or other coverage. They are not supposed to do cash sometimes and insurance other times if they are in network with your insurance. In sum, that is how it is done with insurance and that is how the orthotist gets reimbursed for their time etc.
The “possible” downside for you here is that the cost is going to be higher. Typically that cost will be tied to an L1930 hcpc code. That price comes in at approximately : $193.00 , for the plastic AFOs we have shown here above. This is an approximation that should be pretty close, but know that different insurances reimburse the same hcpc code at different rates so that number may vary. Thus the approximation of cost shown. The orthotist does not make up the price for the code. They are held to the price by the rules of our profession and the insurance company. Remember, these are the costs of these braces without add ons like pads or extra straps.
The upside for you here is that the brace specialist has to do work. They have to get you the right size and make sure it doesn’t rub on bones or hurt you. If it is wrong, they have to get you another one at no extra cost to you or they have to adjust the one you have in case you took it thinking it was fine and then had an issue.
You do not have to worry about shipping it back if there is a problem. You also do not have to hope a return is possible if it touched your skin and then wasn’t right. Remember that once you take these things home because you are good with the fit and then change your mind, it gets way way harder to return them. Trial them out extensively at the orthotic visit so you know you are happy.
Moreover, the orthotist has to show you in depth how it works. If something goes wrong with the walking aid, the problem could be on them, so they are interested for that reason alone to make sure you are doing well. They should do what’s right anyways but you get the point.
In general, our company does not promote these kinds of plastic, prefab afos but they do exist and you should be aware of general costs if you decide to go this route. The plastic ones shown might be perfect for you, but you should at least check out other options that we will show you below.
2.) Prefabricated Carbon Graphite AFOs
This picture shown in this section illustrates what is known as a carbon graphite AFO. We had professional sketches done as to not have any problems with copyright, but the drawing are very good depictions of what they look like. If you want to see other brand names, you can search for “carbon graphite afo” online and those brand names will come up.
You can see that the one to the left here looks kind of like a spiral, right? Thus the name: spiral AFO. If you look online, the cost can quickly be found for : $ 621.56. This is the price you get without having it billed to any insurance or other coverage. Again, the upside is that you might get it cheaper than an orthotist can give to you, but you might not be able to return it to an online vendor and the sizing of it is your responsibility.
The hcpc code for this spiral shape AFO shown above is L1951. That price equates to approximately $645, without padding. It may also have a code of L2820, which signifies below knee padding. (We suggest getting the padding for Carbon type of AFOs when possible). That cost is approximately : $62.00. Therefore, you are basically looking a a price of $707.00, without any add ons.
This style of brace (carbon graphite) is very light weight and this is a major upside of this kind of walking aid. It is also thinner so it can fit into more shoes. This is good for those fashionistas out there that won’t settle for anything but dress shoes. : ) An orthotist will charge your insurance approximately $707.00, as stated earlier. Again, the L code reimbursement for each (otherwise known as the hcpc code) is dependent on the contract that any given provider has with your insurance and it subject to fluctuate from time to time.
The picture seen to the right is also an AFO. It is also made of carbon graphite. This AFO can be very effective for not only treating foot drop, but also for indirectly treating a knee that buckles. One internet cost we just came up with sells this at $242, while another site sells it at $345. If you average that cost you get : $293.50 before shipping and taxes.
Often times knees that buckle (a fall starter) and foot drop, go hand in hand. The one to the right here also has the unique aspect of being known for its light weight qualities and also for fitting into more shoes.
Plus it, like the plastic AFO mentioned above, are known for the speed at which they can be provided on an average basis to patients who have specific time requirements to get the brace (like less than 8 hours, for example). This is the upside of a brace that is prefabricated. A custom one typically has a one day turn around. The prefabricated one was most likely made even before you ever knew you had a walking challenge.
Each of thee carbon AFOs, if you take a closer look, do not have a heel or a midfoot area that will cause discomfort. You can compare that to the plastic ones above. Meaning there is nothing to rub on your skin from the AFO.
But remember, if you are not an expert in gait mechanics, you might not want to just go and spend this money out of pocket. Thus the benefit of working with an orthotist. Also, if you have insurance, you could pay way less than $242 or $395. Your personal cost could be zero, depending on coverage and your deductible. Your orthotic company should be able to give you a better understanding (for free) if you go and see them about the costs you personally will have, ahead of time.
Custom Made AFOs
Ok. Now that we have covered many of the common types of prefabricated AFOs, lets move on to our next category. Custom.
Typically custom made AFOs are made from thermoplastic, but an exception does exist that we will cover later in this article. These AFOs are typically made for walking purposes.
The image to the left is a picture of a custom made AFO that is “prearticulated” in design. If the afo had a hinge that moved it would be called “articulated”. Typically there is a hinge inside each style and the code for this device is L1970. You are not going to find an online retailer selling this item. Why? Because it is made from a custom impression of your leg and foot. This is key for those features that we touched on above. Such as heel shape and midfoot shape. Moreover, we could also talk about arch height, the need to control intoeing etc. But this is a post on price. The L1970 code gets you in at approximately : $531.00, prior to any add on codes such as below knee padding (L2820) etc. So the base price for this is approximately what is shown above.
If you decide, or you and your orthotist decide to make upgrades the following choices would have costs :
1.) Varus / valgus correction : If your toe swings inward, or your ankle rolls then a code L2275 could be used. The general cost on this is : $100.00
2.) Below Knee Padding : As stated earlier, that code is L2820 and its price is approximately : $62.00
3.) Custom Pretibial Shell : Another common addition to these braces is the use of a pretibial shell. This helps to avoid knee buckling (a fall starter) and can be used for fracture care purposes. That code is L2340. The price of that code approximately is : $321.00.
This is one example of a pretibial shell. They can come in different colors and sometimes have a slightly different shape, but in essence, the afo to the right has a pretibial shell. The straps help to hold it onto the front of the walking brace. It can be a very useful component for the right person when it comes to AFOs, but not everyone will get one of these shells. Also, you can see the ankle joint area is cut on this brace and thus it would no longer be considered prearticulated, but instead “articulated”.
4.) Lastly, a dorsiflexion / plantar flexion control code could be incorporated into the AFO and that code is L2200. That is the bumper thin you see on the back of the AFO toward the heel. That price is approximately : $39.00
The add on costs are generally not going to vary, but what can vary is the fact that the AFO is prearticulated, articulated or without a hinge. The picture shown to the right is a “solid” ankle AFO. Its Lcode in many parts of the country is L1960. The approximate cost for this type of custom walking aid is : $476.00 A custom non hinged ankle foot orthosis can come in around this price. The plastic around the ankle area could change, but basically this is the price.
All the same add ons above still could apply.
So, for a plastic custom afo you are looking at a range of approximately : $476 – $1053.00
Basically, the more intense the walking problem, the more the cost could go up to help support the individual trying to walk and perform activities of daily living.
Again, your cost could be found somewhere within that range mentioned above, or it could be zero, if you have insurance. A reputable company will help you figure that out the best they can prior to providing treatment in a process called “insurance verification”. An orthotics company typically never charges for that kind of a service so you can find out the benefits you have for your particular plan. If you are in a position where you are paying cash, you will at least have a reference point. These are all out patient costs and not inpatient costs, by the way and this needs to be considered as well.
Gauntlet Type AFOs
In the last section of this post, we will be talking about ankle gauntlets. These are usually custom made. They are typically provided for pain reasons and can be extremely valuable for the right person. We have a patient who has so much pain in her feet that she almost had to close her shop because she just couldn’t walk anymore. She did not have a foot drop problem, but rather it was something more along with arthritis and overall pain. This AFO helps to limit the motion that causes the pain and it also supports the arch. Good stuff!
Anyhow, this particular AFO has three codes assigned to it.
1.) L1940. Plastic AFO interior. Cost : $374.00
2.) L2330 : Lacer = $282.00
3.) L2820 : Below Knee Interface / Padding : $62.00
Total Price approximation : $718.00
We hope this article has been helpful for you. We covered the most common types of AFOs used today. Some we did not cover due to enfringement on possible copyright with brand names, but their prices should not be too far off from what we have covered here. These prices are approximations but they should be close to what you will be charged. If you have any questions, feel free to contact us at 1-866-RINELLA, or if you are local you can call 1-815-717-8970 (we serve patient’s currently in the state of Illinois).
*Rinella Prosthetics and Orthotics, Inc is not responsible for any price discrepancies that you may encounter. Price depends on factors that are specific to each person and if we do not participate in your care we can not control the prices that you will be charged.