HCPCS L4394
Replace soft interface material, foot drop splint
Current codeBelow Knee Orthotic23 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $20.80 – $22.10 | $10.40 | $26.00 |
| Deaconess Medical Center | $18.46 – $18.98 | $10.40 | $26.00 |
| Mary Bridge Children's Hospital | $17.00 – $20.80 | $10.40 | $26.00 |
| MultiCare Auburn Medical Center | $15.34 – $18.98 | $10.40 | $26.00 |
| MultiCare Covington Medical Center | $15.34 – $18.98 | $10.40 | $26.00 |
| MultiCare Good Samaritan Hospital | $15.34 – $18.98 | $10.40 | $26.00 |
| MultiCare Valley Hospital | $18.72 | $10.40 | $26.00 |
| Tacoma General Allenmore Hospital | $15.34 – $18.98 | $10.40 | $26.00 |
| Yakima Valley Memorial | $14.56 | $10.40 | $26.00 |
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
- $20.22 (fee)