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Washington rates for HCPCS L4394

Replace soft interface material, foot drop splint

Facilitymedian $20 · 10th–90th $13–$490%10%10th90th$20Professionalmedian $13 · 10th–90th $9–$300%10%10th90th$13$0.2$1.0$5.0$20.0$100.0

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
$12.88 / $12.88 / $31.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $10.96 / $18.20
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.38 / $19.50 / $19.50
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $17.38 / $22.39
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
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.75 / $26.92 / $56.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $23.44 / $43.65
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $20.42 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $19.50 / $19.95
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $19.95 / $20.42
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.38 / $28.84 / $39.81
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.60 / $16.60 / $19.50
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $19.50 / $19.50
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $17.38 / $22.39
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.12 / $30.20 / $30.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.51 / $10.00 / $17.38
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $17.38 / $30.20