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Utah rates for HCPCS L4394

Replace soft interface material, foot drop splint

Facilitymedian $10 · 10th–90th $5–$200%20%40%10th90th$10Professionalmedian $14 · 10th–90th $5–$870%10%10th90th$14$10.0$20.0$50.0

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $5.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $10.96 / $87.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $13.49 / $13.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $9.77 / $13.49
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $15.14 / $30.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $20.42 / $20.42
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $14.79 / $22.39
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $20.42 / $20.89
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.79 / $20.89 / $23.99
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.59 / $9.12 / $10.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.24 / $9.12 / $15.14