Men's high-top depth-inlay shoes

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

Mens shoes hightop depth inl

Molina pricing summary

Low

$20

Average

$64

Median

$49

High

$154

Molina rate distribution

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38 hospital rates

#		Plans
1	AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient	1	$28	$28	—	—	—	$28 – $28
2	BAKERSFIELD MEMORIAL HOSPITAL Bakersfield, CA fee schedule · outpatient	1	$84	$84	—	—	—	$84 – $84
3	CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient	1	$27	$27	—	—	—	$27 – $27
4	CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient	1	$49	$49	—	—	—	$49 – $49
5	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient	1	$30	$30	—	—	—	$30 – $30
6	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient	1	$31	$31	—	—	—	$31 – $31
7	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient	1	$32	$32	—	—	—	$32 – $32
8	CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · fee schedule · outpatient	1	$59	$59	—	—	—	$59 – $59
9	COMMUNITY HOSPITAL OF SAN BERNARDINO San Bernardino, CA fee schedule · inpatient	1	$173	$173	—	—	—	$173 – $173
10	COMMUNITY HOSPITAL OF SAN BERNARDINO San Bernardino, CA fee schedule · outpatient	1	$118	$118	—	—	—	$118 – $118
11	Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient	1	$27	$27	—	—	—	$27 – $27
12	DIGNITY COMMUNITY CARE Glendale, CA fee schedule · inpatient	1	$173	$173	—	—	—	$173 – $173
13	DIGNITY COMMUNITY CARE Glendale, CA fee schedule · outpatient	1	$118	$118	—	—	—	$118 – $118
14	DIGNITY HEALTH Bakersfield, CA fee schedule · outpatient	2	$84	$84	—	—	—	$84 – $84
15	DIGNITY HEALTH San Bernardino, CA fee schedule · inpatient	2	$173	$173	—	—	—	$173 – $173
16	DIGNITY HEALTH San Bernardino, CA fee schedule · outpatient	2	$119	$119	—	—	—	$119 – $119
17	DIGNITY HEALTH Merced, CA fee schedule · outpatient	2	$84	$84	—	—	—	$84 – $84
18	DIGNITY HEALTH Long Beach, CA fee schedule · inpatient	1	$173	$173	—	—	—	$173 – $173
19	DIGNITY HEALTH Long Beach, CA fee schedule · outpatient	1	$118	$118	—	—	—	$118 – $118
20	FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER Fresno, CA facility · fee schedule · outpatient	1	$59	$59	—	—	—	$59 – $59
21	Fairview Hospital Cleveland, OH facility · case rate · outpatient	1	$29	$29	—	—	—	$29 – $29
22	Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient	1	$20	$20	—	—	—	$20 – $20
23	GRITMAN MEDICAL CENTER INC Moscow, ID facility · fee schedule · outpatient	1	$46	$46	—	—	—	$46 – $46
24	Highland Hospital Rochester, NY fee schedule · outpatient	2	$76	$76	—	—	—	$76 – $76
25	LODI COMMUNITY HOSPITAL Lodi, OH facility · case rate · outpatient	1	$47	$47	—	—	—	$47 – $47