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
PRE-TIBIAL SHELL MOLDED TO P
Low
$178
Average
$841
Median
$807
High
$1.7k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
54 payers; the 90th percentile is 2.7× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare fee schedule · outpatient · +18 other terms | 383 | $633 | $683 | $311 | 46% | — | $1 – $2.8k |
| 2 | Aetna fee schedule · outpatient · +19 other terms | 362 | $640 | $706 | $370 | 52% | — | $312 – $4.2k |
| 3 | Humana fee schedule · outpatient · +18 other terms | 319 | $626 | $929 | $1.0k | 111% | — | $264 – $4.9k |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +18 other terms | 236 | $639 | $821 | $494 | 60% | — | $0 – $6.9k |
| 5 | WellCare fee schedule · outpatient · +8 other terms | 209 | $656 | $654 | $92 | 14% | — | $495 – $1.1k |
| 6 | Devoted fee schedule · outpatient · +4 other terms | 165 | $626 | $621 | $46 | 7% | — | $493 – $698 |
| 7 | Molina fee schedule · outpatient · +13 other terms | 148 | $797 | $843 | $326 | 39% | — | $306 – $1.7k |
| 8 | Cigna fee schedule · outpatient · +15 other terms | 116 | $645 | $856 | $416 | 49% | — | $359 – $2.1k |
| 9 | Cigna Healthspring fee schedule · outpatient · +3 other terms | 116 | $650 | $640 | $37 | 6% | — | $514 – $705 |
| 10 | Anthem fee schedule · outpatient · +15 other terms | 90 | $514 | $960 | $784 | 82% | — | $289 – $3.9k |
| 11 | Kaiser fee schedule · outpatient · +10 other terms | 74 | $524 | $1.0k | $728 | 72% | — | $376 – $4.7k |
| 12 | Ambetter facility · fee schedule · outpatient · +7 other terms | 46 | $959 | $1.1k | $296 | 27% | — | $373 – $1.6k |
| 13 | Caresource fee schedule · outpatient · +5 other terms | 41 | $626 | $541 | $108 | 20% | — | $289 – $794 |
| 14 | Superior Healthplan fee schedule · outpatient · +1 other terms | 40 | $669 | $668 | $3 | 0% | — | $624 – $669 |
| 15 | Clover fee schedule · outpatient · +3 other terms | 37 | $626 | $609 | $56 | 9% | — | $547 – $685 |
| 16 | Oscar fee schedule · outpatient · +7 other terms | 36 | $658 | $728 | $181 | 25% | — | $565 – $1.2k |
| 17 | Optum fee schedule · outpatient · +8 other terms | 33 | $626 | $785 | $370 | 47% | — | $493 – $1.6k |
| 18 | Medica facility · fee schedule · outpatient · +9 other terms | 22 | $525 | $482 | $126 | 26% | — | $171 – $861 |
| 19 | Medicare fee schedule · outpatient · +3 other terms | 19 | $493 | $500 | $21 | 4% | — | $493 – $594 |
| 20 | Regence facility · fee schedule · outpatient · +6 other terms | 19 | $534 | $548 | $26 | 5% | — | $514 – $607 |
| 21 | Amerihealth Caritas fee schedule · outpatient · +4 other terms | 18 | $752 | $737 | $26 | 4% | — | $675 – $752 |
| 22 | Bcbs Tx fee schedule · outpatient | 18 | $624 | $624 | — | — | — | $624 – $624 |
| 23 | Tricare facility · fee schedule · outpatient · +6 other terms | 18 | $655 | $614 | $62 | 10% | — | $502 – $662 |
| 24 | Medical Mutual facility · fee schedule · outpatient · +2 other terms | 15 | $514 | $595 | $147 | 25% | — | $280 – $811 |
| 25 | Highmark facility · fee schedule · outpatient · +6 other terms | 14 | $1.1k | $1.1k | $457 | 42% | — | $558 – $1.9k |
← Hospitals reporting HCPCS L2340 · Snapshot 20261111T120946Z-9134e7f7