HCPCS L4394
Replace soft interface material, foot drop splint
Current codeBelow Knee Orthotic23 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 | $19.82 – $21.80 | $10.40 | $26.00 |
| Deaconess Medical Center | $19.82 – $21.80 | $10.40 | $26.00 |
| Harborview Medical Center | $20.22 – $22.24 | — | — |
| Kadlec Regional Medical Center | $20.22 – $24.26 | — | — |
| Mary Bridge Children's Hospital | $19.82 – $21.80 | $10.40 | $26.00 |
| MultiCare Auburn Medical Center | $19.82 – $21.80 | $10.40 | $26.00 |
| MultiCare Covington Medical Center | $19.82 – $21.80 | $10.40 | $26.00 |
| MultiCare Good Samaritan Hospital | $19.82 – $21.80 | $10.40 | $26.00 |
| MultiCare Valley Hospital | $20.41 – $21.80 | $10.40 | $26.00 |
| Overlake Hospital Medical Center & Clinics | $20.22 – $21.03 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $20.22 – $24.26 | — | — |
| Providence Centralia Hospital | $20.22 – $32.35 | — | — |
| Providence Regional Medical Center Everett | $20.22 – $22.24 | — | — |
| Providence St Peter Hospital | $20.22 – $32.35 | — | — |
| Swedish Edmonds Hospital | $20.22 – $24.26 | — | — |
| Swedish Issaquah | $20.22 – $24.26 | — | — |
| Swedish Medical Center | $20.22 – $24.26 | — | — |
| Swedish Medical Center / Cherry Hill | $20.22 – $24.26 | — | — |
| Tacoma General Allenmore Hospital | $19.82 – $21.80 | $10.40 | $26.00 |
| University of Washington Medical Ctr | $20.22 – $22.24 | — | — |
| Virginia Mason Medical Center | $13.87 – $20.81 | — | — |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $19.82 – $22.19 | $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)