Non-inflatable walking boot, off-the-shelf at Medical City Plano

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
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Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

IMMOBLZR BOOT W/AIR LRG

Plano, TX

See all hospitals reporting HCPCS L4387 →

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Pricing by billing methodology

Price type

How this price compares nationally

Medical City Plano’s median price of $199 is 3% above the median hospital's median price ($193), higher than 62% of the 1,239 hospitals reporting HCPCS L4387. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L4387 at Medical City Plano

Negotiated rates from the hospital’s own file: 11 payers, 51 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	Superior Healthplan chip percent of total billed charges · outpatientfrom % of charges	$25	$25	—	—	—	$25 – $25
2	Superior Healthplan mcdstar percent of total billed charges · outpatientfrom % of charges	$25	$25	—	—	—	$25 – $25
3	Superior Healthplan starhealth percent of total billed charges · outpatientfrom % of charges	$25	$25	—	—	—	$25 – $25
4	Superior Healthplan starkids percent of total billed charges · outpatientfrom % of charges	$25	$25	—	—	—	$25 – $25
5	Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges	$25	$25	—	—	—	$25 – $25
6	Cigna ifp percent of total billed charges · outpatientfrom % of charges	$49	$49	—	—	—	$49 – $49
7	Cigna qhp percent of total billed charges · outpatientfrom % of charges	$51	$51	—	—	—	$51 – $51
8	UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges	$63	$63	—	—	—	$63 – $63
9	Blue Cross Blue Shield blueadvantagehmo percent of total billed charges · outpatientfrom % of charges	$89	$89	—	—	—	$89 – $89
10	Blue Cross Blue Shield mybluehealth percent of total billed charges · outpatientfrom % of charges	$89	$89	—	—	—	$89 – $89
11	Cigna localplus percent of total billed charges · outpatientfrom % of charges	$95	$95	—	—	—	$95 – $95
12	Cigna newbusiness percent of total billed charges · outpatientfrom % of charges	$95	$95	—	—	—	$95 – $95
13	Cigna hmo percent of total billed charges · outpatientfrom % of charges	$107	$107	—	—	—	$107 – $107
14	Cigna networkbenefit percent of total billed charges · outpatientfrom % of charges	$107	$107	—	—	—	$107 – $107
15	Cigna openaccessplus percent of total billed charges · outpatientfrom % of charges	$107	$107	—	—	—	$107 – $107
16	Blue Cross Blue Shield blueessentials percent of total billed charges · outpatientfrom % of charges	$115	$115	—	—	—	$115 – $115
17	Blue Cross Blue Shield blueessentialsaccess percent of total billed charges · outpatientfrom % of charges	$115	$115	—	—	—	$115 – $115
18	Blue Cross Blue Shield eposoa percent of total billed charges · outpatientfrom % of charges	$121	$121	—	—	—	$121 – $121
19	Healthcare Highways cityofplano percent of total billed charges · outpatientfrom % of charges	$122	$122	—	—	—	$122 – $122
20	Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges	$126	$126	—	—	—	$126 – $126
21	Cigna allother percent of total billed charges · outpatientfrom % of charges	$135	$135	—	—	—	$135 – $135
22	Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges	$160	$160	—	—	—	$160 – $160
23	Humana tricare fee schedule · outpatient	$190	$190	—	—	—	$190 – $190
24	Aetna asa percent of total billed charges · outpatientfrom % of charges	$190	$190	—	—	—	$190 – $190
25	Blue Cross Blue Shield mcrppo fee schedule · outpatient	$192	$192	—	—	—	$192 – $192

Page 1 of 3 · 51 rates

Last updated: Mar 1, 2026

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