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
FOR DIABETICS ONLY, MULTIPLE DENSITY INSERT, MADE BY DIRECT CARVING WITH CAM TECHNOLOGY FROM A RECTIFIED CAD MODEL CREATED FROM A DIGITIZED SCAN OF THE PATIENT, TOTAL CONTACT WITH PATIENT'S FOOT, INCLUDING ARCH, BASE LAYER MINIMUM OF 3/16 INCH MATERIAL OF
Low
$54
Average
$167
Median
$124
High
$529
Each hospital's average MultiPlan rate, under the methodology and billing class chosen below.
11 hospitals; the 90th percentile is 4.9× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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14 hospital rates
iThe hospitals that file a MultiPlan rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Bexar County Hospital District San Antonio, TX fee schedule · outpatient | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 2 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 1 | $85 | $85 | — | — | — | $85 – $85 |
| 3 | FHN Memorial Hospital Freeport, IL percent of total billed charges · outpatientfrom % of charges | 1 | $91 | $91 | — | — | — | $91 – $91 |
| 4 | Geisinger Medical Center Muncy, PA percent of total billed charges · inpatientfrom % of charges | 2 | $260 | $260 | — | — | — | $260 – $260 |
| 5 | Geisinger Medical Center Muncy, PA percent of total billed charges · outpatientfrom % of charges | 2 | $260 | $260 | — | — | — | $260 – $260 |
| 6 | Geisinger Wyoming Valley Wilkes-Barre, PA percent of total billed charges · inpatientfrom % of charges | 2 | $162 | $162 | — | — | — | $162 – $162 |
| 7 | Geisinger Wyoming Valley Wilkes-Barre, PA percent of total billed charges · outpatientfrom % of charges | 2 | $162 | $162 | — | — | — | $162 – $162 |
| 8 | HMH HOSPITALS CORPORATION North Bergen, NJ facility · fee schedule · outpatient | 1 | $135 | $135 | — | — | — | $135 – $135 |
| 9 | Oroville Hospital Oroville, CA percent of total billed charges · outpatientfrom % of charges | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 10 | The University of Texas Southwestern Medical Center at Dallas Dallas, TX percent of total billed charges · bothfrom % of charges | 1 | $124 | $124 | — | — | — | $124 – $124 |
| 11 | UCHealth Estes Valley Medical Center Estes Park, CO fee schedule · both | 1 | $81 | $81 | — | — | — | $81 – $81 |
| 12 | UNIVERSITY OF MICHIGAN HEALTH Ann Arbor, MI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $264 | $264 | — | — | — | $264 – $264 |
| 13 | UNIVERSITY OF MICHIGAN HEALTH Ann Arbor, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $264 | $264 | — | — | — | $264 – $264 |
| 14 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 2 | $529 | $529 | $37 | 7% | — | $492 – $566 |
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