Infant Oxford shoe with supinator or pronator

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-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Oxford w supinat/pronat inf

Payers reporting HCPCS L3201

Payer pricing summary

Low

Average

$112

Median

$57

High

$1.3k

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +9 other terms	47	$256	$229	$121	53%	—	$18 – $349
2	Blue Cross Blue Shield facility · fee schedule · outpatient · +9 other terms	37	$55	$118	$106	90%	—	$17 – $377
3	UnitedHealthcare fee schedule · both · +11 other terms	26	$21	$40	$25	62%	—	$21 – $98
4	Aetna fee schedule · outpatient · +10 other terms	21	$19	$41	$46	112%	—	$18 – $228
5	Anthem facility · case rate · outpatient · +6 other terms	16	$29	$32	$7	21%	—	$20 – $49
6	Caresource facility · case rate · outpatient · +4 other terms	16	$30	$32	$7	22%	—	$20 – $50
7	Cigna fee schedule · both · +6 other terms	15	$82	$71	$22	31%	—	$20 – $82
8	Molina facility · case rate · outpatient · +4 other terms	15	$29	$31	$7	23%	—	$20 – $49
9	Wellmark fee schedule · both · +3 other terms	13	$45	$46	$4	9%	—	$45 – $70
10	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$180	$124	$89	72%	—	$26 – $225
11	Regence fee schedule · outpatient · +1 other terms	12	$41	$44	$11	26%	—	$32 – $105
12	Optum facility · case rate · outpatient · +1 other terms	11	$27	$30	$7	22%	—	$24 – $44
13	Medica fee schedule · outpatient · +6 other terms	10	$72	$72	$19	26%	—	$44 – $93
14	Aetna Better Health fee schedule · inpatient · +2 other terms	7	$19	$19	—	—	—	$19 – $19
15	Bcbs Ks fee schedule · outpatient · +1 other terms	3	$152	$158	$9	6%	—	$151 – $172
16	First Health professional · fee schedule · both · +4 other terms	3	$20	$20	—	—	—	$20 – $20
17	Excellus fee schedule · outpatient	2	$30	$30	$1	2%	—	$28 – $30
18	Kaiser fee schedule · both · +2 other terms	2	$109	$109	—	—	—	$109 – $109
19	Ambetter facility · fee schedule · outpatient · +1 other terms	1	$17	$17	—	—	—	$17 – $17
20	Bcbs Id facility · fee schedule · outpatient	1	$37	$37	—	—	—	$37 – $37
21	Bcbs Il professional · fee schedule · both	1	$70	$70	—	—	—	$70 – $70
22	Bcbs La facility · fee schedule · outpatient	1	$0	$0	—	—	—	$0 – $0
23	Bcbs Nc facility · fee schedule · outpatient	1	$26	$26	$3	11%	—	$24 – $30
24	Bcbs Nv fee schedule · outpatient	1	$26	$26	—	—	—	$26 – $26
25	Bcbs Vt professional · fee schedule · outpatient	1	$27	$27	—	—	—	$27 – $27

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