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Additional Cast Change and Realignment

Nationwide rates for HCPCS L6386

Immediate postsurgical or early fitting, each additional cast change and realignment

Rates data updated October 2026.

How much does Additional Cast Change and Realignment cost?

$355

Typical negotiated rate. Nationwide, October 2026.

Insurers have agreed to pay about $355 for this service. The price depends on where it is billed: about $339 from a physician practice, and about $479 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 68 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$339$269 to $525
FacilityA hospital or hospital-owned outpatient department$479$355 to $661

How much rates vary

Facilitymedian $479 · 10th to 90th $240 to $1,259Professionalmedian $339 · 10th to 90th $240 to $933
$200$500$1K$2K$5Kfacility $479professional $339

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$204.17
Median
$346.74
Typical High
$537.03
Aetna
Setting
Professional
Modifier
None (both parts)
Typical Low
$213.80
Median
$281.84
Typical High
$467.74
AllWays Health Partners
Setting
Facility
Modifier
None
Typical Low
$512.86
Median
$512.86
Typical High
$1,548.82
AllWays Health Partners
Setting
Professional
Modifier
None (both parts)
Typical Low
$213.80
Median
$549.54
Typical High
$3,162.28
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$380.19
Median
$676.08
Typical High
$1,698.24
Anthem BCBS
Setting
Professional
Modifier
None (both parts)
Typical Low
$281.84
Median
$309.03
Typical High
$870.96
Asuris Northwest Health
Setting
Facility
Modifier
None
Typical Low
$426.58
Median
$537.03
Typical High
$575.44
Asuris Northwest Health
Setting
Professional
Modifier
None (both parts)
Typical Low
$478.63
Median
$3,162.28
Typical High
$4,897.79
AvMed
Setting
Facility
Modifier
None
Typical Low
$489.78
Median
$489.78
Typical High
$489.78
AvMed
Setting
Professional
Modifier
None (both parts)
Typical Low
$363.08
Median
$457.09
Typical High
$489.78
BCBS
Setting
Facility
Modifier
None
Typical Low
$371.54
Median
$588.84
Typical High
$1,445.44
BCBS
Setting
Professional
Modifier
None (both parts)
Typical Low
$331.13
Median
$467.74
Typical High
$588.84
Blue Shield
Setting
Facility
Modifier
None
Typical Low
$389.05
Median
$933.25
Typical High
$1,584.89
Blue Shield
Setting
Professional
Modifier
None (both parts)
Typical Low
$724.44
Median
$1,348.96
Typical High
$2,398.83
CDPHP
Setting
Professional
Modifier
None (both parts)
Typical Low
$537.03
Median
$537.03
Typical High
$537.03
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$4,265.80
Median
$5,011.87
Typical High
$79,432.82
Capital Blue Cross
Setting
Professional
Modifier
None (both parts)
Typical Low
$446.68
Median
$549.54
Typical High
$549.54
CareFirst
Setting
Professional
Modifier
None (both parts)
Typical Low
$295.12
Median
$295.12
Typical High
$389.05
CareSource
Setting
Facility
Modifier
None
Typical Low
$316.23
Median
$407.38
Typical High
$691.83
CareSource
Setting
Professional
Modifier
None (both parts)
Typical Low
$407.38
Median
$575.44
Typical High
$776.25
Central California Alliance for Health
Setting
Professional
Modifier
None (both parts)
Typical Low
$223.87
Median
$245.47
Typical High
$524.81
Christus
Setting
Facility
Modifier
None
Typical Low
$549.54
Median
$549.54
Typical High
$549.54
Cigna
Setting
Facility
Modifier
None
Typical Low
$363.08
Median
$363.08
Typical High
$616.60
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$269.15
Median
$269.15
Typical High
$660.69
ConnectiCare
Setting
Facility
Modifier
None
Typical Low
$354.81
Median
$354.81
Typical High
$354.81
ConnectiCare
Setting
Professional
Modifier
None (both parts)
Typical Low
$354.81
Median
$407.38
Typical High
$724.44
Contra Costa Health
Setting
Professional
Modifier
None
Typical Low
$223.87
Median
$660.69
Typical High
$724.44
DeanCare
Setting
Facility
Modifier
None
Typical Low
$154.88
Median
$562.34
Typical High
$645.65
DeanCare
Setting
Professional
Modifier
None (both parts)
Typical Low
$323.59
Median
$562.34
Typical High
$691.83
Denver HMP
Setting
Facility
Modifier
None
Typical Low
$154.88
Median
$309.03
Typical High
$616.60
Denver HMP
Setting
Professional
Modifier
None (both parts)
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
Emblem Health
Setting
Facility
Modifier
None
Typical Low
$660.69
Median
$1,071.52
Typical High
$2,344.23
Emblem Health
Setting
Professional
Modifier
None (both parts)
Typical Low
$426.58
Median
$724.44
Typical High
$1,096.48
Excellus BCBS
Setting
Facility
Modifier
None
Typical Low
$309.03
Median
$309.03
Typical High
$309.03
Excellus BCBS
Setting
Professional
Modifier
None (both parts)
Typical Low
$309.03
Median
$389.05
Typical High
$537.03
Fallon Health
Setting
Facility
Modifier
None
Typical Low
$83.18
Median
$3,630.78
Typical High
$9,772.37
Florida Blue
Setting
Facility
Modifier
None
Typical Low
$912.01
Median
$912.01
Typical High
$912.01
Florida Blue
Setting
Professional
Modifier
None (both parts)
Typical Low
$295.12
Median
$489.78
Typical High
$489.78
Geisinger
Setting
Facility
Modifier
None
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
Geisinger
Setting
Professional
Modifier
None (both parts)
Typical Low
$288.40
Median
$338.84
Typical High
$562.34
HMSA
Setting
Professional
Modifier
None (both parts)
Typical Low
$707.95
Median
$707.95
Typical High
$741.31
Hally Health
Setting
Professional
Modifier
None
Typical Low
$478.63
Median
$616.60
Typical High
$1,412.54
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
None (both parts)
Typical Low
$741.31
Median
$741.31
Typical High
$741.31
Harvard Pilgrim
Setting
Professional
Modifier
None (both parts)
Typical Low
$213.80
Median
$478.63
Typical High
$524.81
Health Alliance Plan
Setting
Facility
Modifier
None
Typical Low
$323.59
Median
$1,096.48
Typical High
$1,202.26
Health Alliance Plan
Setting
Professional
Modifier
None (both parts)
Typical Low
$323.59
Median
$446.68
Typical High
$575.44
Health New England
Setting
Professional
Modifier
None (both parts)
Typical Low
$309.03
Median
$309.03
Typical High
$309.03
Health Partners
Setting
Facility
Modifier
None
Typical Low
$1,230.27
Median
$1,949.84
Typical High
$4,570.88
Health Partners
Setting
Professional
Modifier
None (both parts)
Typical Low
$660.69
Median
$660.69
Typical High
$660.69
Hometown Health
Setting
Professional
Modifier
None
Typical Low
$371.54
Median
$588.84
Typical High
$1,096.48
Horizon BCBS
Setting
Professional
Modifier
None (both parts)
Typical Low
$426.58
Median
$426.58
Typical High
$426.58
Johns Hopkins Employer Health Plan
Setting
Professional
Modifier
None (both parts)
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$389.05
Median
$588.84
Typical High
$1,122.02
Kaiser Permanente
Setting
Facility
Modifier
None
Typical Low
$537.03
Median
$676.08
Typical High
$1,000.00
Kaiser Permanente
Setting
Professional
Modifier
None (both parts)
Typical Low
$512.86
Median
$691.83
Typical High
$1,071.52
Lucent Health
Setting
Professional
Modifier
None (both parts)
Typical Low
$3,162.28
Median
$4,897.79
Typical High
$4,897.79
MVP Health Care
Setting
Facility
Modifier
None
Typical Low
$660.69
Median
$660.69
Typical High
$660.69
MVP Health Care
Setting
Professional
Modifier
None (both parts)
Typical Low
$380.19
Median
$380.19
Typical High
$954.99
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$245.47
Median
$245.47
Typical High
$245.47
Martin's Point
Setting
Professional
Modifier
None (both parts)
Typical Low
$245.47
Median
$257.04
Typical High
$295.12
Mass General Brigham
Setting
Facility
Modifier
None
Typical Low
$512.86
Median
$512.86
Typical High
$1,548.82
Mass General Brigham
Setting
Professional
Modifier
None (both parts)
Typical Low
$213.80
Median
$549.54
Typical High
$3,162.28
Medcost
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$363.08
Typical High
$512.86
Medcost
Setting
Facility
Modifier
None
Typical Low
$154.88
Median
$302.00
Typical High
$489.78
Medcost
Setting
Professional
Modifier
None (both parts)
Typical Low
$269.15
Median
$338.84
Typical High
$575.44
Medica
Setting
Facility
Modifier
None
Typical Low
$288.40
Median
$562.34
Typical High
$2,630.27
Medica
Setting
Professional
Modifier
None (both parts)
Typical Low
$218.78
Median
$354.81
Typical High
$3,090.30
Medical Mutual of Ohio
Setting
Facility
Modifier
None
Typical Low
$363.08
Median
$363.08
Typical High
$363.08
Medical Mutual of Ohio
Setting
Professional
Modifier
None (both parts)
Typical Low
$269.15
Median
$269.15
Typical High
$363.08
Midlands
Setting
Professional
Modifier
None
Typical Low
$602.56
Median
$724.44
Typical High
$758.58
Midlands
Setting
Facility
Modifier
None
Typical Low
$616.60
Median
$616.60
Typical High
$616.60
Midlands
Setting
Professional
Modifier
None (both parts)
Typical Low
$501.19
Median
$912.01
Typical High
$1,380.38
Moda Health
Setting
Facility
Modifier
None
Typical Low
$154.88
Median
$354.81
Typical High
$549.54
Moda Health
Setting
Professional
Modifier
None (both parts)
Typical Low
$234.42
Median
$416.87
Typical High
$562.34
Molina
Setting
Professional
Modifier
None (both parts)
Typical Low
$81.28
Median
$295.12
Typical High
$489.78
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$371.54
Median
$707.95
Typical High
$30,199.52
MountainHealth Co-op
Setting
Professional
Modifier
None (both parts)
Typical Low
$489.78
Median
$707.95
Typical High
$39,810.72
Network Health
Setting
Facility
Modifier
None
Typical Low
$912.01
Median
$912.01
Typical High
$912.01
Network Health
Setting
Professional
Modifier
None (both parts)
Typical Low
$407.38
Median
$524.81
Typical High
$977.24
Optum
Setting
Professional
Modifier
None (both parts)
Typical Low
$54.95
Median
$54.95
Typical High
$70.79
Oscar Health
Setting
Professional
Modifier
None (both parts)
Typical Low
$398.11
Median
$676.08
Typical High
$977.24
Pacific Source
Setting
Facility
Modifier
None
Typical Low
$436.52
Median
$537.03
Typical High
$549.54
Pacific Source
Setting
Professional
Modifier
None (both parts)
Typical Low
$478.63
Median
$549.54
Typical High
$549.54
Physicians Health Plan of Northern Indiana
Setting
Facility
Modifier
None
Typical Low
$912.01
Median
$954.99
Typical High
$2,137.96
Physicians Health Plan of Northern Indiana
Setting
Professional
Modifier
None (both parts)
Typical Low
$354.81
Median
$467.74
Typical High
$691.83
Premera BCBS
Setting
Facility
Modifier
None
Typical Low
$489.78
Median
$489.78
Typical High
$1,071.52
Premera BCBS
Setting
Professional
Modifier
None (both parts)
Typical Low
$457.09
Median
$457.09
Typical High
$630.96
Prevea360
Setting
Facility
Modifier
None
Typical Low
$154.88
Median
$562.34
Typical High
$645.65
Prevea360
Setting
Professional
Modifier
None (both parts)
Typical Low
$323.59
Median
$562.34
Typical High
$645.65
Priority Health
Setting
Facility
Modifier
None
Typical Low
$363.08
Median
$363.08
Typical High
$363.08
Priority Health
Setting
Professional
Modifier
None (both parts)
Typical Low
$269.15
Median
$363.08
Typical High
$467.74
Providence
Setting
Facility
Modifier
None
Typical Low
$229.09
Median
$363.08
Typical High
$562.34
Providence
Setting
Professional
Modifier
None (both parts)
Typical Low
$269.15
Median
$269.15
Typical High
$501.19
Quartz
Setting
Professional
Modifier
None
Typical Low
$537.03
Median
$870.96
Typical High
$1,230.27
Quartz
Setting
Facility
Modifier
None
Typical Low
$363.08
Median
$363.08
Typical High
$380.19
Quartz
Setting
Professional
Modifier
None (both parts)
Typical Low
$269.15
Median
$269.15
Typical High
$363.08
Regence BlueShield
Setting
Facility
Modifier
None
Typical Low
$457.09
Median
$537.03
Typical High
$1,862.09
Regence BlueShield
Setting
Professional
Modifier
None (both parts)
Typical Low
$346.74
Median
$478.63
Typical High
$616.60
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$416.87
Median
$478.63
Typical High
$562.34
Select Health
Setting
Facility
Modifier
None
Typical Low
$489.78
Median
$575.44
Typical High
$977.24
Select Health
Setting
Professional
Modifier
None (both parts)
Typical Low
$371.54
Median
$524.81
Typical High
$660.69
Sentara
Setting
Facility
Modifier
None
Typical Low
$269.15
Median
$389.05
Typical High
$1,202.26
Sentara
Setting
Professional
Modifier
None (both parts)
Typical Low
$288.40
Median
$416.87
Typical High
$851.14
SummaCare
Setting
Professional
Modifier
None (both parts)
Typical Low
$575.44
Median
$588.84
Typical High
$912.01
Sutter Health Plus
Setting
Professional
Modifier
None (both parts)
Typical Low
$1,202.26
Median
$1,202.26
Typical High
$1,202.26
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$302.00
Median
$389.05
Typical High
$676.08
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$263.03
Median
$1,202.26
Typical High
$2,041.74
UPMC Health Plan
Setting
Professional
Modifier
None (both parts)
Typical Low
$263.03
Median
$263.03
Typical High
$524.81
United
Setting
Facility
Modifier
None
Typical Low
$239.88
Median
$323.59
Typical High
$660.69
United
Setting
Professional
Modifier
None (both parts)
Typical Low
$199.53
Median
$281.84
Typical High
$478.63
Univera
Setting
Facility
Modifier
None
Typical Low
$309.03
Median
$309.03
Typical High
$389.05
Univera
Setting
Professional
Modifier
None (both parts)
Typical Low
$309.03
Median
$389.05
Typical High
$537.03
University Health Alliance
Setting
Professional
Modifier
None (both parts)
Typical Low
$436.52
Median
$436.52
Typical High
$436.52
Well Sense
Setting
Facility
Modifier
None
Typical Low
$489.78
Median
$645.65
Typical High
$954.99
Well Sense
Setting
Professional
Modifier
None (both parts)
Typical Low
$354.81
Median
$354.81
Typical High
$426.58
Wellmark
Setting
Professional
Modifier
None (both parts)
Typical Low
$549.54
Median
$549.54
Typical High
$549.54
Wellpoint
Setting
Professional
Modifier
None (both parts)
Typical Low
$257.04
Median
$288.40
Typical High
$478.63
40 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$102.33
Median
$173.78
Typical High
$269.15
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$41.69
Median
$70.79
Typical High
$107.15
Aetna
Setting
Facility
Modifier
55 · Aftercare only
Typical Low
$30.90
Median
$52.48
Typical High
$79.43
Aetna
Setting
Facility
Modifier
56 · Pre-op care only
Typical Low
$20.42
Median
$34.67
Typical High
$53.70
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$107.15
Median
$141.25
Typical High
$234.42
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$42.66
Median
$57.54
Typical High
$93.33
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$32.36
Median
$42.66
Typical High
$70.79
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$21.38
Median
$28.18
Typical High
$46.77
Anthem BCBS
Setting
Professional
Modifier
26 · Professional part
Typical Low
$29.51
Median
$43.65
Typical High
$56.23
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$29.51
Median
$37.15
Typical High
$295.12
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$218.78
Median
$218.78
Typical High
$489.78
BCBS
Setting
Professional
Modifier
22 · Increased work
Typical Low
$489.78
Median
$645.65
Typical High
$645.65
BCBS
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$331.13
Median
$331.13
Typical High
$331.13
BCBS
Setting
Professional
Modifier
78 · Unplanned return to OR
Typical Low
$371.54
Median
$416.87
Typical High
$436.52
BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
Capital Blue Cross
Setting
Professional
Modifier
50 · Both sides
Typical Low
$501.19
Median
$549.54
Typical High
$549.54
Health Alliance Plan
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Health Alliance Plan
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Health Alliance Plan
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$47.86
Median
$47.86
Typical High
$47.86
Health Alliance Plan
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$32.36
Median
$32.36
Typical High
$32.36
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$123.03
Median
$128.82
Typical High
$147.91
Martin's Point
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$48.98
Median
$52.48
Typical High
$58.88
Martin's Point
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$37.15
Median
$38.90
Typical High
$43.65
Martin's Point
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$24.55
Median
$25.70
Typical High
$29.51
Medcost
Setting
Professional
Modifier
26 · Professional part
Typical Low
$134.90
Median
$144.54
Typical High
$323.59
Medcost
Setting
Professional
Modifier
50 · Both sides
Typical Low
$407.38
Median
$512.86
Typical High
$1,288.25
Medcost
Setting
Professional
Modifier
51 · Multiple procedures
Typical Low
$134.90
Median
$169.82
Typical High
$426.58
Medcost
Setting
Professional
Modifier
80 · Assistant surgeon
Typical Low
$53.70
Median
$67.61
Typical High
$169.82
Medcost
Setting
Professional
Modifier
81 · Minimal assistant surgeon
Typical Low
$38.02
Median
$47.86
Typical High
$120.23
Medcost
Setting
Professional
Modifier
82 · Assistant surgeon, no resident
Typical Low
$38.02
Median
$47.86
Typical High
$120.23
Medcost
Setting
Professional
Modifier
AS · PA/NP assist
Typical Low
$38.02
Median
$47.86
Typical High
$120.23
Medcost
Setting
Professional
Modifier
SH · Second concurrent infusion
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
Medcost
Setting
Professional
Modifier
SJ · Third+ concurrent infusion
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
Medcost
Setting
Professional
Modifier
TC · Technical part
Typical Low
$204.17
Median
$218.78
Typical High
$489.78
Moda Health
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$117.49
Median
$125.89
Typical High
$234.42
Moda Health
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$46.77
Median
$51.29
Typical High
$93.33
Moda Health
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$35.48
Median
$38.02
Typical High
$69.18
Moda Health
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$23.44
Median
$25.12
Typical High
$46.77
Premera BCBS
Setting
Facility
Modifier
NR · New when rented
Typical Low
$489.78
Median
$489.78
Typical High
$489.78
Premera BCBS
Setting
Professional
Modifier
NR · New when rented
Typical Low
$457.09
Median
$457.09
Typical High
$630.96

What it costs in each state

The same service costs 2.6 times more in Hawaii than in Vermont. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Touch or drag across the chart to see any state's rate.

HI $708VT $269

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.