HCPCS L4387
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf
Current codeBelow Knee Orthotic30 hospitals with prices
What Washington hospitals publish for this code
Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.
| Hospital | Medicare Advantage rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $186 – $205 | $93.60 – $96.80 | $234 – $242 |
| Deaconess Medical Center | $186 – $205 | $93.60 – $96.80 | $234 – $242 |
| Harborview Medical Center | $190 – $209 | — | — |
| Highline Medical Center | — | $56.12 | $184 |
| Kadlec Regional Medical Center | $190 – $228 | — | — |
| Mary Bridge Children's Hospital | $186 – $205 | $93.60 – $96.80 | $234 – $242 |
| MultiCare Auburn Medical Center | $186 – $205 | $93.60 – $96.80 | $234 – $242 |
| MultiCare Covington Medical Center | $186 – $205 | $93.60 – $96.80 | $234 – $242 |
| MultiCare Good Samaritan Hospital | $186 – $205 | $93.60 – $96.80 | $234 – $242 |
| MultiCare Valley Hospital | $192 – $205 | $93.60 – $96.80 | $234 – $242 |
| Overlake Hospital Medical Center & Clinics | $190 – $198 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $190 – $228 | — | — |
| Providence Centralia Hospital | $190 – $304 | — | — |
| Providence Regional Medical Center Everett | $190 – $209 | — | — |
| Providence St Peter Hospital | $190 – $304 | — | — |
| St Anthony Hospital | — | $55.90 | $184 |
| St Clare Hospital | — | $52.98 | $184 |
| St Elizabeth Hospital | $33.09 – $40.44 | $64.95 | $184 |
| St Francis Community Hospital | — | $57.68 | $184 |
| St Joseph Medical Center | — | $60.87 | $184 |
| St Michael Medical Center | — | $81.12 | $184 |
| Swedish Edmonds Hospital | $190 – $228 | — | — |
| Swedish Issaquah | $190 – $228 | $252 | $526 |
| Swedish Medical Center | $190 – $228 | $252 | $526 |
| Swedish Medical Center / Cherry Hill | $190 – $228 | $252 | $526 |
| Tacoma General Allenmore Hospital | $186 – $205 | $93.60 – $96.80 | $234 – $242 |
| University of Washington Medical Ctr | $190 – $209 | — | — |
| Virginia Mason Medical Center | $131 – $196 | — | — |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $186 – $209 | $56.40 – $96.80 | $141 – $242 |
Medicare (traditional) reference
Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.
- Equipment fee, Washington
- $190 (fee)