Replacement soft interface for static ankle-foot orthosis

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

SET TRACTION BOOT LINER SM

Payers reporting HCPCS L4392

Payer pricing summary

Low

$15

Average

$37

Median

$32

High

$79

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +16 other terms	367	$29	$35	$19	55%	—	$14 – $186
2	UnitedHealthcare fee schedule · outpatient · +17 other terms	359	$29	$29	$7	25%	—	$13 – $92
3	Humana fee schedule · outpatient · +15 other terms	319	$29	$43	$47	108%	—	$15 – $224
4	Blue Cross Blue Shield fee schedule · outpatient · +10 other terms	227	$30	$38	$19	51%	—	$0 – $139
5	WellCare fee schedule · outpatient · +5 other terms	209	$30	$31	$5	15%	—	$28 – $55
6	Devoted fee schedule · outpatient · +4 other terms	165	$29	$29	$1	3%	—	$28 – $35
7	Molina fee schedule · outpatient · +8 other terms	139	$41	$40	$15	38%	—	$18 – $76
8	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$30	$30	$1	4%	—	$29 – $35
9	Cigna fee schedule · outpatient · +14 other terms	109	$30	$34	$10	29%	—	$28 – $85
10	Anthem fee schedule · outpatient · +12 other terms	82	$29	$32	$35	108%	—	$2 – $217
11	Kaiser fee schedule · outpatient · +6 other terms	71	$29	$49	$32	65%	—	$18 – $204
12	Superior Healthplan fee schedule · outpatient	40	$31	$31	$0	0%	—	$29 – $31
13	Clover fee schedule · outpatient · +3 other terms	37	$29	$29	$2	5%	—	$28 – $34
14	Oscar fee schedule · outpatient · +3 other terms	36	$31	$33	$7	20%	—	$29 – $49
15	Ambetter facility · fee schedule · outpatient · +6 other terms	35	$52	$54	$13	24%	—	$29 – $73
16	Optum fee schedule · outpatient · +4 other terms	34	$29	$37	$16	42%	—	$18 – $73
17	Caresource fee schedule · outpatient · +4 other terms	28	$29	$31	$8	26%	—	$17 – $45
18	Medica facility · fee schedule · outpatient · +5 other terms	22	$30	$27	$7	26%	—	$10 – $46
19	Regence facility · fee schedule · outpatient · +3 other terms	19	$30	$29	$2	8%	—	$23 – $30
20	Amerihealth Caritas fee schedule · outpatient · +3 other terms	18	$35	$34	$2	6%	—	$29 – $35
21	Bcbs Tx fee schedule · outpatient	18	$29	$29	—	—	—	$29 – $29
22	Medicare fee schedule · outpatient · +1 other terms	18	$28	$28	$0	1%	—	$28 – $28
23	Premera fee schedule · outpatient · +1 other terms	16	$45	$45	$9	20%	—	$18 – $67
24	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$29	$33	$8	25%	—	$16 – $46
25	Bcbs Mn fee schedule · outpatient · +6 other terms	13	$26	$26	$6	23%	—	$13 – $31

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