How Much Do Custom Orthotics Cost?

Unlike over-the-counter orthotics (OTCs), which are generic, custom orthotics are specially designed to address your specific foot conditions. They’re made to improve and support your foot posture or treat any foot pathology you’re experiencing.

Custom orthotics are functional, accommodating, and therapeutic. You won’t feel them when you walk, but you’ll feel the benefits of putting less stress on your joints and a stable gait. Because they’re highly customized, custom orthotics are usually pricier. But how much are custom orthotics, you ask? At PrimeCare, we specialize in custom orthotic solutions and are ready to share our knowledge and expertise. Read on to find out more about these life-changing medical devices.

The Average Cost of Custom Orthotics vs. Premade

Average prices on custom orthotics range from $100 to $1,000 and more. Making custom orthotics is a multistep process — that’s why they’re more expensive.

Premade options are significantly cheaper. However, they should exclusively be used for mild conditions. They’re not as effective because their materials are of inferior quality. This means they don’t perform as well or last as long as custom orthotics.

The cost of orthotics can vary significantly depending on various factors, such as the type, materials, customization level, and the provider's expertise and location.

Average Prices on Over-the-Counter Orthotics in the US

Over-the-counter (OTC, premade) orthotics: These are prefabricated, non-custom insoles found in drugstores and retail outlets. They offer basic support and cushioning for common foot problems like flat feet or plantar fasciitis.

• Average price range: $20 - $150.

Average Cost of Custom Orthotics in the US

Here’s a more comprehensive overview of different custom orthotic types available in the USA.

Semi-custom orthotics: These orthotics start with a prefabricated base but can be modified to a certain extent by the provider. They offer a balance between affordability and personalization.

• ‍Average price range: $60 - $300.

Custom orthotics are made specifically for your feet based on a cast or 3D scan. They provide the most precise and personalized support for a variety of foot conditions, including those related to biomechanical abnormalities, gait issues, or specific medical conditions like diabetes.

• Average price range: $100 - $1000.

Custom orthotic variations:

• ‍Non-casted custom orthotics: Crafted using measurements and foot impressions, these offer a more tailored fit than OTC insoles, but at a lower cost than fully casted orthotics.
• Functional orthotics: These target specific biomechanical issues and aim to improve function, reduce foot and heel pain, and prevent further injuries.
• Accommodative orthotics: Providing cushioning and shock absorption, these are ideal for conditions like arthritis or diabetes where comfort and pressure relief are paramount.

How Does the Cost of Custom Orthotics Differ by Type?

• Custom orthotic insoles: These are tailored shoe inserts designed to correct biomechanical issues, provide support, and alleviate pain. Average Price Range: $200 - $800 (depending on casting methods, materials, and provider's expertise).
• Ankle foot orthotics (AFOs): One of the main types of custom foot orthotics, consisting of braces supporting the ankle and foot, addressing conditions like foot drop or instability. Prices range from $500 - $2,000, with materials like carbon fiber impacting cost.
• Knee ankle foot orthotics (KAFOs): These are more extensive braces that encompass the knee, ankle, and foot, used for conditions affecting multiple joints or requiring greater stability. Prices can range from $1,000 - $5,000 or more, depending on the materials (e.g., metal or plastic) and the level of customization.
• Knee orthotics (KOs): Braces designed to support the knee joint, often used for osteoarthritis or ligament injuries. Prices range from $200 - $1,000, depending on complexity and materials.
• Wrist hand orthotics (WHOs): Braces to stabilize the wrist and hand, used for conditions like carpal tunnel syndrome or arthritis. Prices typically fall between $100 - $500.
• Spinal orthotics (SOs): Braces supporting and correcting the spine for conditions like scoliosis or fractures. Costs can vary greatly, ranging from $500 - $3,000 or more depending on the materials (e.g., rigid vs. flexible) and the extent of customization.

Additional Costs to Consider

• Professional fitting: Depending on the type of orthotic and the provider, you may need to pay for a consultation and fitting, which can range from $50 to $200 or more.
• Follow-up appointments: Some custom orthotics may require adjustments or follow-up appointments which adds to the overall cost.
• Insurance coverage: Some insurance plans may cover a portion of the cost of orthotics, particularly if they’re deemed medically necessary for treating a specific condition. Always check with your insurance provider to understand your coverage benefits.

Important Considerations

While cost is a factor, prioritizing the quality and effectiveness of the orthotic is crucial. Investing in well-made, properly fitted orthotics can provide significant pain relief, improve foot and body function, and prevent further complications. If you’re experiencing foot pain or discomfort, consulting with a podiatrist or other foot specialist can help determine if orthotics are the right solution for you. They can recommend the appropriate type of orthotic and make sure it fits properly for maximum benefit.

How Much Do Orthotics Cost with Insurance?

Insurance coverage for custom orthotics can vary significantly depending on your insurance plan and specific medical needs. Generally speaking, if you have health insurance, you can expect to pay between 10% — 15% out-of-pocket of the total custom orthotics price.

Factors Influencing Insurance Coverage

• Medical necessity: Most insurance plans require that the orthotics be prescribed by a licensed healthcare professional and considered medically necessary to treat a specific condition.
• Type of orthotic: Some plans differentiate between different types of orthotics, offering more coverage for custom-molded orthotics compared to prefabricated ones.
• Deductibles and co-pays: Even if your insurance covers orthotics, you may still be responsible for deductibles or co-pays, depending on your plan.

Please note: Custom-made orthotics prices are only covered by custom orthotics when orthotics are in place in a shoe attached to a leg brace. There are no exceptions to this rule.

Unfortunately, not all health insurance plans cover the cost of orthotics. That’s why, at PrimeCare Prosthetics, we offer a variety of payment options.

Why Are Custom Orthotics Pricier than OTCs?

Custom orthotics often come with a higher price tag compared to over-the-counter orthotics, and this discrepancy isn't without reason. The cost difference stems from several key factors that differentiate custom orthotics and contribute to their superior efficacy and personalized fit. Let's delve into the reasons behind their higher price.

#1. The Manufacturing Process

Fabricating orthotics is a multistep process that factors in your symptoms, pathology, activity, and footwear. Your podiatrist will design an orthotic for your individual needs and purposes, like children’s orthotics or orthotics for athletes. Before doing so, you’ll need to have a foot examination, which may require additional imaging to assess underlying pathology. From there, the manufacturing process begins.

#2. Specialist Doctor Visits

Custom orthotics are fabricated by specialists — usually podiatrists, sports medicine practitioners, or orthopedic doctors. They will take a cast of your foot (or foot impressions). Once the plaster is set, they’ll remove the cast from your feet. This is then sent to a state-of-the-art orthotic laboratory, where it’s handmade by highly skilled technicians, which is why the cost of custom insoles is higher than that of already-made orthotics.

#3. Materials

The first thing many of our orthotic patients ask is, “How much do custom-made orthotics cost?” This depends on the types of materials used, like polypropylene or graphite, and various cushioning options, such as neoprene, silicone, and ethylene-vinyl acetate. These materials are rigid with some flexibility to offer enough range of motion while reducing the chances of injury.

#4. Customization

Custom orthotics differ not only in the materials used but also in their shape. Once the design work is complete, your orthotics need to be milled. This process entails carving an orthotics shell out of the materials your podiatrist has prescribed. This customization process takes time and skilled labor which is factored into how much your custom insoles cost.

Are Orthotics Worth It?

Instead of asking, “How much do custom orthotics cost?” you should ask, "Are custom orthotics worth it?" Custom devices are made of high-quality, durable, longer-lasting materials, even if you need readjustments down the line.

So, are custom orthotics worth it? In short, absolutely, but only if you buy good-quality ones. Think of it as an investment in your health that returns multiple dividends. Having good physical health improves your mental health and saves you money as you won’t need to constantly replace cheaper orthotics.

Moreover, OTCs aren’t meant to address your specific issues. Yet, custom orthotics have greater longevity and are uniquely designed especially for you.

Find Your Custom Orthotic Solution Today

While the cost of custom orthotics can vary depending on various factors, their potential benefits can far outweigh the initial investment. Don't let the price deter you from exploring the potential advantages of custom orthotics.

At PrimeCare, a top orthotics and prosthetics provider in New Mexico, we understand that each individual's needs are unique, and we are dedicated to providing personalized orthotic solutions that address you personally. Our team of experienced professionals will work closely with you to assess your condition, create a custom orthotic that fits perfectly, and provide ongoing support to ensure optimal results. Call us today for custom orthotic solutions!