Removable premolded metatarsal arch support

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

Insole Pwrstp F Full M 9-9.5

Payers reporting HCPCS L3050

Payer pricing summary

Low

$15

Average

$67

Median

$58

High

$210

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Aetna fee schedule · outpatient · +14 other terms	361	$58	$67	$31	46%	—	$29 – $377
2	UnitedHealthcare fee schedule · outpatient · +14 other terms	361	$58	$58	$16	27%	—	$1 – $187
3	Humana fee schedule · outpatient · +14 other terms	317	$58	$87	$93	107%	—	$30 – $447
4	Blue Cross Blue Shield fee schedule · outpatient · +13 other terms	231	$59	$76	$39	51%	—	$0 – $277
5	WellCare fee schedule · outpatient · +7 other terms	208	$60	$61	$9	15%	—	$55 – $110
6	Devoted fee schedule · outpatient · +4 other terms	165	$58	$58	$1	2%	—	$56 – $70
7	Molina fee schedule · outpatient · +8 other terms	139	$83	$80	$30	37%	—	$43 – $152
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$59	$59	$2	3%	—	$58 – $71
9	Cigna fee schedule · outpatient · +14 other terms	102	$60	$66	$18	27%	—	$56 – $169
10	Anthem fee schedule · outpatient · +10 other terms	80	$57	$80	$76	96%	—	$55 – $434
11	Kaiser fee schedule · outpatient · +5 other terms	65	$60	$99	$68	69%	—	$56 – $414
12	Ambetter facility · fee schedule · outpatient · +5 other terms	42	$98	$104	$27	26%	—	$42 – $145
13	Superior Healthplan fee schedule · outpatient	40	$61	$61	$0	0%	—	$57 – $61
14	Clover fee schedule · outpatient · +3 other terms	37	$58	$59	$3	5%	—	$55 – $69
15	Oscar fee schedule · outpatient · +3 other terms	36	$61	$67	$14	21%	—	$57 – $98
16	Optum fee schedule · outpatient · +4 other terms	33	$58	$76	$31	40%	—	$56 – $145
17	Caresource fee schedule · outpatient · +4 other terms	26	$58	$66	$13	20%	—	$58 – $89
18	Medica facility · fee schedule · outpatient · +9 other terms	22	$59	$54	$14	26%	—	$19 – $96
19	Regence facility · fee schedule · outpatient · +6 other terms	19	$61	$58	$5	8%	—	$47 – $62
20	Amerihealth Caritas fee schedule · outpatient · +3 other terms	18	$70	$68	$4	6%	—	$58 – $70
21	Bcbs Tx fee schedule · outpatient	18	$57	$57	—	—	—	$57 – $57
22	Medicare fee schedule · outpatient · +1 other terms	18	$56	$56	$0	1%	—	$56 – $57
23	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$58	$67	$16	25%	—	$31 – $91
24	Bcbs Mn fee schedule · outpatient · +6 other terms	13	$53	$53	$12	23%	—	$26 – $62
25	Wellmark fee schedule · both · +3 other terms	13	$54	$53	$2	3%	—	$42 – $54

Page 1 of 3 · 54 payers