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.
Original text from hospital filings
BRACE FOOT-UP SHOELESS WRAP XL
Arlington, TX
See all hospitals reporting HCPCS L1930 →Price type
AMH Cath Labs LLC’s median price of $110 is 63% below the median hospital's median price ($297), higher than 15% of the 1,359 hospitals reporting HCPCS L1930. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 31 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield managed medicaid percent of total billed charges · outpatientfrom % of charges | $12 | $19 | $20 | 100% | — | $9 – $88 |
| 2 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $12 | $19 | $20 | 100% | — | $9 – $88 |
| 3 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $13 | $20 | $20 | 100% | — | $9 – $92 |
| 4 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $13 | $21 | $21 | 100% | — | $9 – $95 |
| 5 | Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges | $13 | $21 | $21 | 100% | — | $9 – $96 |
| 6 | Blue Cross Blue Shield exchange percent of total billed charges · outpatientfrom % of charges | $43 | $68 | $68 | 100% | — | $30 – $305 |
| 7 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $56 | $90 | $90 | 100% | — | $39 – $404 |
| 8 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $69 | $109 | $110 | 100% | — | $48 – $492 |
| 9 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $75 | $119 | $120 | 100% | — | $52 – $539 |
| 10 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $76 | $121 | $121 | 100% | — | $53 – $544 |
| 11 | Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges | $76 | $121 | $122 | 100% | — | $53 – $547 |
| 12 | Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges | $76 | $121 | $122 | 100% | — | $53 – $547 |
| 13 | UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges | $87 | $137 | $138 | 100% | — | $60 – $620 |
| 14 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $92 | $145 | $146 | 100% | — | $64 – $656 |
| 15 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $95 | $152 | $152 | 100% | — | $67 – $684 |
| 16 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $96 | $152 | $153 | 100% | — | $67 – $686 |
| 17 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $96 | $153 | $154 | 100% | — | $67 – $690 |
| 18 | Aetna coventry percent of total billed charges · outpatientfrom % of charges | $96 | $153 | $154 | 100% | — | $67 – $690 |
| 19 | Phcs ppo percent of total billed charges · inpatientfrom % of charges | $102 | $162 | $163 | 100% | — | $71 – $733 |
| 20 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $120 | $190 | $191 | 100% | — | $83 – $856 |
| 21 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $120 | $190 | $191 | 100% | — | $83 – $856 |
| 22 | Cigna indemnity percent of total billed charges · inpatientfrom % of charges | $129 | $205 | $206 | 100% | — | $90 – $926 |
| 23 | Cigna indemnity percent of total billed charges · outpatientfrom % of charges | $129 | $205 | $206 | 100% | — | $90 – $926 |
| 24 | Blue Cross Blue Shield medicare advantage case rate · outpatient | $362 | $362 | — | — | — | $362 – $362 |
| 25 | Humana medicare advantage case rate · outpatient | $377 | $377 | — | — | — | $377 – $377 |
Last updated: Apr 21, 2026
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