Custom molded Plastazote shoe insert

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

Shoe molded plastazote cust

Payers reporting HCPCS L3252

Payer pricing summary

Low

Average

$240

Median

$206

High

$642

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +8 other terms	45	$872	$857	$386	45%	—	$61 – $1.2k
2	Blue Cross Blue Shield facility · fee schedule · outpatient · +10 other terms	33	$268	$491	$386	79%	—	$158 – $1.7k
3	UnitedHealthcare fee schedule · both · +11 other terms	26	$73	$137	$85	62%	—	$71 – $335
4	Aetna fee schedule · outpatient · +11 other terms	19	$68	$146	$162	111%	—	$62 – $778
5	Anthem facility · case rate · outpatient · +4 other terms	15	$318	$348	$82	23%	—	$216 – $540
6	Caresource facility · case rate · outpatient · +1 other terms	15	$324	$348	$80	23%	—	$216 – $550
7	Cigna fee schedule · both · +8 other terms	15	$281	$249	$57	23%	—	$134 – $281
8	Molina facility · case rate · outpatient · +3 other terms	15	$318	$348	$81	23%	—	$223 – $540
9	Wellmark fee schedule · both	13	$217	$217	—	—	—	$217 – $217
10	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$850	$640	$364	57%	—	$268 – $1.1k
11	Clover facility · percent of total billed charges · outpatientfrom % of charges	12	$108	$99	$30	30%	—	$1 – $108
12	Regence fee schedule · outpatient · +1 other terms	12	$138	$150	$39	26%	—	$108 – $357
13	Optum facility · case rate · outpatient · +1 other terms	11	$300	$330	$74	22%	—	$271 – $488
14	Highmark fee schedule · outpatient · +1 other terms	10	$199	$199	—	—	—	$199 – $199
15	Medica fee schedule · outpatient · +4 other terms	10	$246	$246	$63	26%	—	$149 – $317
16	Ucare fee schedule · both · +3 other terms	9	$292	$292	—	—	—	$292 – $292
17	Aetna Better Health fee schedule · inpatient · +1 other terms	7	$63	$63	—	—	—	$63 – $63
18	WellCare percent of total billed charges · bothfrom % of charges · +1 other terms	5	$87	$87	—	—	—	$87 – $87
19	Bcbs Ks fee schedule · outpatient · +1 other terms	3	$166	$172	$10	6%	—	$165 – $187
20	First Health professional · fee schedule · both	3	$70	$70	—	—	—	$70 – $70
21	Kaiser fee schedule · both · +1 other terms	2	$370	$370	—	—	—	$370 – $370
22	Medicaid fee schedule · outpatient	2	$1	$1	—	—	—	$1 – $1
23	Bcbs Id professional · fee schedule · outpatient	1	$152	$152	—	—	—	$152 – $152
24	Bcbs La facility · fee schedule · outpatient	1	$0	$0	—	—	—	$0 – $0
25	Bcbs Nc facility · fee schedule · outpatient	1	$111	$111	$41	37%	—	$82 – $170

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