Removable molded foot insert (UCB-type shell)

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

C CTUO FOOT INSERT, REMOVABLE, MOLDED TO PATIENT MODEL, CUSTOM (BA)

Payers reporting HCPCS L3000

Payer pricing summary

Low

$132

Average

$398

Median

$388

High

$684

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +23 other terms	377	$392	$394	$138	35%	—	$1 – $1.3k
2	Aetna fee schedule · outpatient · +21 other terms	363	$390	$447	$205	46%	—	$193 – $2.5k
3	Humana fee schedule · outpatient · +21 other terms	321	$386	$562	$610	108%	—	$80 – $3.0k
4	Blue Cross Blue Shield fee schedule · outpatient · +21 other terms	224	$396	$510	$270	53%	—	$0 – $1.9k
5	WellCare fee schedule · outpatient · +12 other terms	208	$400	$410	$61	15%	—	$369 – $735
6	Devoted fee schedule · outpatient · +5 other terms	165	$388	$390	$9	2%	—	$375 – $469
7	Molina fee schedule · outpatient · +16 other terms	145	$548	$525	$200	38%	—	$85 – $1.0k
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$396	$395	$14	3%	—	$388 – $473
9	Cigna fee schedule · outpatient · +18 other terms	109	$400	$464	$165	36%	—	$242 – $1.2k
10	Anthem fee schedule · outpatient · +19 other terms	86	$383	$525	$521	99%	—	$57 – $2.9k
11	Kaiser fee schedule · outpatient · +11 other terms	68	$398	$612	$416	68%	—	$326 – $2.8k
12	Ambetter facility · fee schedule · outpatient · +10 other terms	44	$617	$691	$180	26%	—	$280 – $970
13	Caresource fee schedule · outpatient · +8 other terms	41	$388	$381	$95	25%	—	$80 – $597
14	Superior Healthplan fee schedule · outpatient · +3 other terms	40	$408	$407	$2	0%	—	$381 – $408
15	Clover fee schedule · outpatient · +5 other terms	37	$388	$391	$21	5%	—	$369 – $460
16	Oscar fee schedule · outpatient · +10 other terms	36	$408	$448	$95	21%	—	$380 – $653
17	Optum fee schedule · outpatient · +11 other terms	33	$388	$507	$205	41%	—	$372 – $970
18	Medica facility · fee schedule · outpatient · +12 other terms	22	$395	$362	$94	26%	—	$129 – $640
19	Regence facility · fee schedule · outpatient · +6 other terms	21	$406	$394	$33	8%	—	$314 – $440
20	Amerihealth Caritas fee schedule · outpatient · +2 other terms	18	$466	$453	$26	6%	—	$384 – $466
21	Bcbs Tx fee schedule · outpatient	18	$381	$381	—	—	—	$381 – $381
22	Medicare fee schedule · outpatient · +6 other terms	18	$375	$376	$3	1%	—	$375 – $383
23	Medical Mutual facility · fee schedule · outpatient · +5 other terms	15	$386	$445	$110	25%	—	$210 – $610
24	Bcbs Mn fee schedule · outpatient · +6 other terms	13	$351	$351	$82	23%	—	$171 – $411
25	Tricare facility · fee schedule · outpatient · +5 other terms	13	$377	$374	$11	3%	—	$339 – $383

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