Repl leath cuff kafo prox th

Reported by 75 hospitals in the network under the fee schedule methodology.

Filter by billing methodology

Reflects negotiated fee schedule rates with commercial payers.

National pricing summary

Low

$75

Average

$139

Median

$133

High

$284

#	Hospital	Location
1	Virginia Mason Medical Center	Seattle, WA	$157	$234	$142	—	$110	$556
2	IHC Health Services Inc., DBA Intermountain Health Intermountain Medical Center	Murray, UT	$120	$178	$89	—	$118	$339
3	IHC Health Services Inc., DBA Intermountain Health Utah Valley Hospital	Provo, UT	$125	$177	$90	—	$99	$339
4	IHC Health Services Inc., DBA Intermountain Health McKay-Dee Hospital	Ogden, UT	$125	$173	$86	—	$100	$339
5	IHC Health Services Inc., DBA Intermountain Health St George Regional Hospital	St. George, UT	$120	$132	$37	—	$115	$284
6	IHC Health Services Inc., DBA Intermountain Health LDS Hospital	Salt Lake City, UT	$125	$178	$86	—	$115	$339
7	Scl Health - Montana, Dba Intermountain Health St. Vincent Healthcare	Billings, MT	$201	$198	$63	—	$118	$323
8	Saint Joseph Hospital, Inc. Dba Intermountain Nhealth Saint Joseph Hospital	DENVER, CO	$179	$185	$75	—	$116	$306
9	IHC Health Services Inc., DBA Intermountain Health Logan Regional Hospital	Logan, UT	$120	$136	$47	—	$100	$284
10	St. Mary's Hospital & Medical Center, Inc. Dba Intermountain Health St. Mary's Regional Hospital	JUNCTION, CO	$167	$148	$27	—	$118	$173

Page 1 of 8

Ask Claude or any MCP client for CPT L4100 pricing at a specific hospital — see how to connect.