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Wisconsin rates for HCPCS L4360

Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Facilitymedian $316 · 10th–90th $174–$5750%50%10th90th$316Professionalmedian $240 · 10th–90th $123–$5130%10%20%10th90th$240$0.5$2.0$10.0$50.0$200.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $194.98 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $186.21 / $426.58
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $524.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $354.81
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $524.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $724.44 / $1,548.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $457.09 / $602.56
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $257.04 / $389.05
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $467.74 / $588.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $309.03 / $1,621.81
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $177.83 / $354.81
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $204.17
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $501.19
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $354.81 / $630.96
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $478.63 / $933.25
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $630.96 / $1,737.80
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $281.84 / $2,041.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $181.97 / $316.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $186.21 / $707.95