Benesch boot pair for infants

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

Benesch boot pair infant

Payers reporting HCPCS L3212

Payer pricing summary

Low

Average

$66

Median

$54

High

$192

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +5 other terms	46	$285	$258	$133	52%	—	$20 – $388
2	Blue Cross Blue Shield facility · fee schedule · outpatient · +5 other terms	26	$84	$144	$110	76%	—	$36 – $498
3	UnitedHealthcare fee schedule · both · +7 other terms	26	$24	$45	$28	62%	—	$23 – $110
4	Aetna fee schedule · outpatient · +5 other terms	19	$22	$48	$53	111%	—	$20 – $254
5	Anthem facility · case rate · outpatient · +4 other terms	15	$29	$31	$7	23%	—	$20 – $49
6	Caresource facility · case rate · outpatient · +1 other terms	15	$29	$31	$7	23%	—	$20 – $50
7	Cigna fee schedule · both · +3 other terms	15	$92	$79	$24	31%	—	$22 – $92
8	Molina facility · case rate · outpatient · +3 other terms	15	$29	$31	$7	23%	—	$20 – $49
9	Wellmark fee schedule · both · +1 other terms	13	$45	$46	$3	7%	—	$45 – $65
10	Regence fee schedule · outpatient · +1 other terms	12	$45	$49	$13	26%	—	$35 – $117
11	Optum facility · case rate · outpatient	11	$27	$30	$7	22%	—	$24 – $44
12	Highmark fee schedule · outpatient · +2 other terms	10	$24	$24	—	—	—	$24 – $24
13	Medica fee schedule · outpatient · +4 other terms	10	$80	$81	$21	26%	—	$49 – $104
14	Ucare fee schedule · both · +3 other terms	9	$109	$109	—	—	—	$109 – $109
15	Bcbs Mn fee schedule · both · +1 other terms	8	$109	$109	—	—	—	$109 – $109
16	Aetna Better Health fee schedule · inpatient · +1 other terms	7	$21	$21	—	—	—	$21 – $21
17	Bcbs Ks fee schedule · outpatient · +1 other terms	3	$169	$176	$10	6%	—	$168 – $191
18	First Health professional · fee schedule · both	3	$23	$23	—	—	—	$23 – $23
19	Kaiser fee schedule · both · +1 other terms	2	$122	$122	—	—	—	$122 – $122
20	Bcbs Id professional · fee schedule · outpatient	1	$50	$50	—	—	—	$50 – $50
21	Bcbs Il professional · fee schedule · both	1	$65	$65	—	—	—	$65 – $65
22	Bcbs La facility · fee schedule · outpatient	1	$0	$0	—	—	—	$0 – $0
23	Bcbs Nc facility · fee schedule · outpatient	1	$31	$31	$6	20%	—	$27 – $40
24	Bcbs Nv fee schedule · outpatient	1	$29	$29	—	—	—	$29 – $29
25	Bcbs Vt professional · fee schedule · outpatient	1	$31	$31	—	—	—	$31 – $31

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