Women's high-top depth shoe

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

Ladies shoes hightop depth i

Payers reporting HCPCS L3217

Payer pricing summary

Low

Average

$123

Median

$89

High

$404

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +6 other terms	46	$611	$553	$286	52%	—	$43 – $832
2	Blue Cross Blue Shield facility · fee schedule · outpatient · +6 other terms	37	$153	$290	$251	87%	—	$51 – $1.1k
3	Aetna fee schedule · outpatient · +8 other terms	28	$89	$205	$216	105%	—	$43 – $659
4	UnitedHealthcare fee schedule · both · +9 other terms	26	$51	$96	$59	62%	—	$50 – $235
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 · +6 other terms	15	$197	$170	$51	30%	—	$52 – $197
8	Molina facility · case rate · outpatient · +2 other terms	15	$29	$31	$7	23%	—	$20 – $49
9	Wellmark fee schedule · both · +1 other terms	13	$53	$54	$8	14%	—	$53 – $100
10	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$126	$99	$50	50%	—	$51 – $157
11	Clover facility · percent of total billed charges · outpatientfrom % of charges	12	$25	$23	$7	30%	—	$0 – $25
12	Regence fee schedule · outpatient · +1 other terms	12	$97	$105	$27	26%	—	$76 – $250
13	Optum facility · case rate · outpatient · +1 other terms	11	$27	$30	$7	22%	—	$24 – $44
14	Highmark fee schedule · outpatient · +1 other terms	10	$253	$253	—	—	—	$253 – $253
15	Medica fee schedule · outpatient · +4 other terms	10	$172	$173	$44	26%	—	$104 – $222
16	Aetna Better Health fee schedule · inpatient · +1 other terms	7	$44	$44	—	—	—	$44 – $44
17	Bcbs Ks fee schedule · outpatient · +1 other terms	3	$169	$176	$10	6%	—	$168 – $191
18	First Health professional · fee schedule · both · +2 other terms	3	$49	$49	—	—	—	$49 – $49
19	WellCare facility · percent of total billed charges · outpatientfrom % of charges	3	$62	$62	—	—	—	$62 – $62
20	Kaiser fee schedule · both	2	$260	$260	—	—	—	$260 – $260
21	Tricare facility · fee schedule · outpatient	2	$348	$348	—	—	—	$348 – $348
22	Bcbs Id facility · fee schedule · outpatient	1	$53	$53	—	—	—	$53 – $53
23	Bcbs Il professional · fee schedule · both	1	$100	$100	—	—	—	$100 – $100
24	Bcbs La facility · fee schedule · outpatient	1	$0	$0	—	—	—	$0 – $0
25	Bcbs Nc facility · fee schedule · outpatient	1	$72	$72	$20	28%	—	$58 – $100

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