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.
Original text from hospital filings
Custom mold shoe remov prost
Low
$0
Average
$560
Median
$317
High
$2.8k
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Prices here combine facility and professional fees. See them separately →Experimental
Reflects negotiated fee schedule rates with commercial payers.
Showing only prices reported under the fee schedule methodology. Choose another in the filter above to change the chart. 313 hospitals; the 90th percentile is 12.9× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | St. Anthony Shawnee Hospital, Inc Shawnee, OK | $316 | $316 | — | — | — | $316 – $316 |
| 2 | Fairview Health Services Edina, MN | $458 | $540 | $441 | 82% | — | $124 – $1.9k |
| 3 | Mayo Regional Hospital Dover Foxcroft, ME | $164 | $144 | $59 | 41% | — | $18 – $195 |
| 4 | Hoopeston Community Memorial Hospital Hoopeston, IL | $115 | $115 | — | — | — | $115 – $115 |
| 5 | Children's Healthcare of Atlanta Atlanta, GA | $293 | $293 | — | — | — | $293 – $293 |
| 6 | William Beaumont Hospital Grosse Pointe, MI | $241 | $241 | $64 | 27% | — | $176 – $305 |
| 7 | Westfield Memorial Hospital Inc WESTFIELD, NY | $330 | $246 | $103 | 42% | — | $31 – $330 |
| 8 | Sanford USD Medical Center Sioux Falls, SD | $124 | $124 | — | — | — | $124 – $124 |
| 9 | Munson Healthcare Charlevoix Hospital Charlevoix, MI | $285 | $284 | $155 | 55% | — | $126 – $438 |
| 10 | Gundersen Luthern Medical Center Inc La Crosse, WI | $138 | $138 | — | — | — | $138 – $138 |
Ask Claude or any MCP client for HCPCS L3250 pricing at a specific hospital — see how to connect.