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Wisconsin rates for HCPCS L4387

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

Facilitymedian $195 · 10th–90th $95$3550%20%40%10th90th$195Professionalmedian $120 · 10th–90th $71$2950%10%20%10th90th$120$0.2$1.0$5.0$20.0$100.0$500.0$2.0K

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
$72.44 / $95.50 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $97.72 / $169.82
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $323.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $181.97 / $218.78
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $309.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $426.58 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $275.42 / $371.54
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $158.49 / $229.09
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $208.93 / $234.42
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $190.55 / $891.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $102.33 / $218.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $93.33
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $229.09 / $478.63
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $295.12 / $537.03
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $389.05 / $891.25
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $177.83 / $954.99
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $100.00 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $134.90 / $389.05