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
FOOT, INSERT, REMOVABLE, MOLDED TO PATIENT MODEL, LONGITUDINAL/ METATARSAL SUPPORT, EACH
Low
$1
Average
$223
Median
$238
High
$533
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
32 hospitals; the 90th percentile is 2.3× 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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35 hospital rates
iThe hospitals that file a Tricare 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 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $240 | $240 | — | — | — | $240 – $240 |
| 2 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 3 | Canton-Potsdam Hospital Potsdam, NY facility · fee schedule · outpatient | 1 | $214 | $214 | — | — | — | $214 – $214 |
| 4 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 5 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 6 | Coulee Medical Center Grand Coulee, WA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $174 | $174 | — | — | — | $174 – $174 |
| 7 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient | 1 | $245 | $245 | — | — | — | $245 – $245 |
| 8 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $245 | $245 | — | — | — | $245 – $245 |
| 9 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $550 | $550 | — | — | — | $550 – $550 |
| 10 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $516 | $516 | — | — | — | $516 – $516 |
| 11 | Garfield County, a political subdivision of the State of Utah, DBA Intermountain Health Garfield Memorial Hospital Panguitch, UT facility · percent of total billed charges · inpatientfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 12 | Garfield County, a political subdivision of the State of Utah, DBA Intermountain Health Garfield Memorial Hospital Panguitch, UT facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 13 | IHC Health Services Inc., DBA Intermountain Primary Children's Hospital City, UT facility · fee schedule · outpatient | 1 | $242 | $242 | — | — | — | $242 – $242 |
| 14 | IHC Health Services Inc., DBA Intermountain Primary Children's Hospital Lehi, UT facility · fee schedule · outpatient | 1 | $242 | $242 | — | — | — | $242 – $242 |
| 15 | Jefferson Health - Northeast Langhorne, PA facility · fee schedule · outpatient | 1 | $238 | $238 | — | — | — | $238 – $238 |
| 16 | Jefferson Health - Northeast Philadelphia, PA facility · fee schedule · outpatient | 1 | $238 | $238 | — | — | — | $238 – $238 |
| 17 | Jefferson Health - Northeast Philadelphia, PA facility · fee schedule · outpatient | 1 | $238 | $238 | — | — | — | $238 – $238 |
| 18 | Kennedy University Hospital, Inc Turnersville, NJ facility · fee schedule · outpatient | 1 | $238 | $238 | — | — | — | $238 – $238 |
| 19 | Kennedy University Hospital, Inc Cherry Hill, NJ facility · fee schedule · outpatient | 1 | $238 | $238 | — | — | — | $238 – $238 |
| 20 | Lansdale Hospital Corp Lansdale, PA facility · fee schedule · outpatient | 1 | $238 | $238 | — | — | — | $238 – $238 |
| 21 | Little Company of Mary Hospital of Indiana Inc Jasper, IN facility · case rate · outpatient | 1 | $242 | $242 | — | — | — | $242 – $242 |
| 22 | Lutheran Musculoskeletal Center LLC Fort Wayne, IN facility · fee schedule · outpatient | 1 | $98 | $98 | $3 | 3% | — | $95 – $101 |
| 23 | MCLAREN FLINT FLINT, MI fee schedule | 1 | $228 | $228 | — | — | — | $228 – $228 |
| 24 | MCLAREN GREATER LANSING LANSING, MI fee schedule | 1 | $223 | $223 | — | — | — | $223 – $223 |
| 25 | METHODIST MEDICAL CENTER OF OAK RIDGE Oak Ridge, TN fee schedule · outpatient | 1 | $245 | $245 | — | — | — | $245 – $245 |
← Payers reporting HCPCS L3020 · Snapshot 20261111T120946Z-9134e7f7