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Utah rates for HCPCS L4387

Walking boot, nonpneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf

Facilitymedian $72 · 10th–90th $63–$790%50%10th90th$72Professionalmedian $135 · 10th–90th $63–$4270%10%10th90th$135$50.0$100.0$200.0$500.0

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
$63.10 / $72.44 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $131.83 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $120.23
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $141.25 / $181.97
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $194.98 / $194.98
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $138.04 / $208.93
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $194.98 / $194.98
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $194.98 / $229.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $85.11 / $91.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $85.11 / $147.91